Healthcare Provider Details

I. General information

NPI: 1790617504
Provider Name (Legal Business Name): DR. KAREN WEIERSTALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 STEWART ST
ROUSES POINT NY
12979-1511
US

IV. Provider business mailing address

7 STEWART ST
ROUSES POINT NY
12979-1511
US

V. Phone/Fax

Practice location:
  • Phone: 518-796-7949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number097.0134674
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: