Healthcare Provider Details

I. General information

NPI: 1932398591
Provider Name (Legal Business Name): MARIANGELA J WEISKOPF LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 PENNICK DR
STEVENSVILLE MD
21666-3628
US

IV. Provider business mailing address

5407 N CHARLES STREET
BALTIMORE MD
21210
US

V. Phone/Fax

Practice location:
  • Phone: 443-262-6516
  • Fax:
Mailing address:
  • Phone: 410-433-8861
  • Fax: 410-433-1249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC1916
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: