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General NPI Number Information
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NPI Number | 1811520638
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Entity Type | Individual
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Provider Name | DOUGLAS WEISKOPF LMHC 11658-MH-CC
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Gender | Male
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 27 JACKSON ST APT 334
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City | LOWELL
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State | MA
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Zip | 01852-2142
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Country | US
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Telephone | 978-905-9960
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Fax |
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Provider Business Mailing Address
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Address Line | 27 JACKSON ST APT 334
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City | LOWELL
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State | MA
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Zip | 01852-2142
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Country | US
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Telephone | 978-905-9960
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11658-MH-CC
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License Number State | MA
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