MR. ANTONIO JAMAAL WIDEMAN PEER SPECIALIST
NPI 1932835238
Peer Specialist in Mattapan, MA

Q: What is Antonio Wideman's NPI number?

The NPI number for Antonio Wideman is 1932835238. It was assigned to this individual provider in the NPPES registry on July 28, 2022.

Q: What is Antonio Wideman's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Q: When was this NPI record last updated?

The NPPES record for Antonio Wideman was last updated on July 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 July 28, 2022

884 CUMMINS HWY APT 4, MATTAPAN, MA 02126(617) 691-6034 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Mr. Antonio Jamaal Wideman Peer Specialist NPPES

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

MR. ANTONIO JAMAAL WIDEMAN PEER SPECIALIST (NPI 1932835238) is an individual peer specialist in Mattapan, Massachusetts, licensed in Massachusetts (202222) and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1932835238

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameMR. ANTONIO JAMAAL WIDEMANCredential: PEER SPECIALIST

Location Address884 CUMMINS HWY APT 4Mattapan, MA 02126-2043

Mailing Address884 Cummins Hwy Apt 4Mattapan, MA 02126-2043 · (617) 691-6034

Phone(617) 691-6034

Sole ProprietorYes

Enumeration DateJuly 28, 2022

NPPES CertifiedJuly 28, 2022

✔ NPI 1932835238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in MA · 202222

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

884 CUMMINS HWY APT 4, Mattapan, MA 02126

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

CONNECTING HUMAN RIGHTS EDUCATION LLC

Case Management

884 CUMMINS HWY APT 4
MATTAPAN, MA 02126

Suffolk County (617) 691-6034

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antonio Wideman's NPI number?

The NPI number for Antonio Wideman is 1932835238. It was assigned to this individual provider in the NPPES registry on July 28, 2022.

Where is Antonio Wideman located?

Antonio Wideman practices at 884 Cummins Hwy Apt 4, Mattapan, MA 02126. The listed phone number is (617) 691-6034.

What is Antonio Wideman's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Antonio Wideman was last updated on July 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.