Healthcare Provider Details

I. General information

NPI: 1326258245
Provider Name (Legal Business Name): NOAH WEINTRAUB PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 TWIN KNOLLS RD STE 7
COLUMBIA MD
21045-3237
US

IV. Provider business mailing address

7879 MAPLE LAWN BLVD
FULTON MD
20759-2548
US

V. Phone/Fax

Practice location:
  • Phone: 410-237-7349
  • Fax:
Mailing address:
  • Phone: 410-499-9028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number04116
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: