MEDICARE: MADISON WEIMER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1568328417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADISON WEIMER LLC

Provider Business Mailing Address
First Line	:	6200 BROOKTREE RD
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-9299
Country	:	US
Telephone Number	:	724-884-5499
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 BROOKTREE RD
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-9299
Country	:	US
Telephone Number	:	724-884-5499
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MADISON WEIMER
Credential	:	LPC
Telephone Number	:	724-884-5499

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/27/2026

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