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General NPI Number Information
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NPI Number | 1114886934
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Entity Type | Organization
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Legal Business Name | VIA THERAPY LLC
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Dates
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Enumeration Date | 01/17/2026
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | N113W13341 CRESTVIEW DR
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City | GERMANTOWN
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State | WI
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Zip | 53022-3610
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Country | US
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Telephone | 262-686-4478
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Fax | 262-208-1483
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Provider Business Mailing Address
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Address Line | 2800 E ENTERPRISE AVE STE 333
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City | APPLETON
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State | WI
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Zip | 54913-7889
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/OWNER
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Name | MR. MICHAEL JAMES WEIDMAN
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Credential | MSW, LCSW, SAC
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Telephone | 262-686-4478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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