MEDICARE: MR. MICHAEL WEINGARTEN M.A., LMFT

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	106H00000X	Marriage & Family Therapist	0055	AK

General Provider Information

NPI Number	:	1982789608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL WEINGARTEN M.A., LMFT

Provider Business Mailing Address
First Line	:	3705 ARCTIC BLVD
Second Line	:	#1516
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5774
Country	:	US
Telephone Number	:	907-301-0424
Fax Number	:

Provider Business Practice Location Address
First Line	:	3705 ARCTIC BLVD
Second Line	:	#1516
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5774
Country	:	US
Telephone Number	:	907-301-0424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	10/14/2008

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