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General NPI Number Information
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NPI Number | 1134280365
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Entity Type | Individual
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Provider Name | LAURENCE WEISMAN PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 148 LINDEN ST SUITE 209
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City | WELLESLEY
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State | MA
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Zip | 02482-7900
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Country | US
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Telephone | 781-235-2662
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Fax | 781-235-2682
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Provider Business Mailing Address
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Address Line | 148 LINDEN ST SUITE 209
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City | WELLESLEY
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State | MA
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Zip | 02482-7900
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Country | US
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Telephone | 781-235-2662
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Fax | 781-235-2682
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 4389
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 4389
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4389
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4389
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License Number State | MA
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