LYNDSEY MICHELLE WIDEMAN MA,LCPC
NPI 1487287835
Counselor - Professional in Carbondale, IL

Q: What is Lyndsey Wideman's NPI number?

The NPI number for Lyndsey Wideman is 1487287835. It was assigned to this individual provider in the NPPES registry on February 13, 2020.

Q: What is Lyndsey Wideman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Lyndsey Wideman was last updated on July 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 13, 2020PECOS EnrolledAccepts Medicare Assignment

2311 S ILLINOIS AVE, CARBONDALE, IL 62903(618) 457-6703(618) 549-3734 Get Directions Write a Review

NPPES record last updated: July 19, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 19, 2023, Feb 13, 2020 (2 updates tracked since 2020).

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About Lyndsey Michelle Wideman Ma,lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LYNDSEY MICHELLE WIDEMAN MA,LCPC (NPI 1487287835) is an individual professional provider in Carbondale, Illinois, licensed in Illinois (180.015448) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1487287835

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameLYNDSEY MICHELLE WIDEMANCredential: MA,LCPC

Location Address2311 S ILLINOIS AVECarbondale, IL 62903-5912

Mailing Address902 W Main StWest Frankfort, IL 62896-2210 · (618) 937-6483 · Fax (618) 937-1440

Phone(618) 457-6703

Fax(618) 549-3734

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateFebruary 13, 2020

Last NPPES UpdateJuly 19, 20232 updates tracked since enumeration

NPPES CertifiedJuly 19, 2023

✔ NPI 1487287835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in IL · 180.015448

2311 S ILLINOIS AVE, Carbondale, IL 62903

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lyndsey Michelle Wideman Ma,lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597115006

PECOS Enrollment IDI20231226001002

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lyndsey Wideman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Centerstone Of Illinois, Inc

21 mi

Mental Health (Including Community Mental Health Center)

902 W MAIN ST
West Frankfort, IL 62896

Reassigned Medicare billing, Illinois enrollment
75 clinicians in this Medicare group

NPI 1053455667 (618) 937-6483

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY MARGARET MACDONALD

Counselor (Mental Health)