MEDICARE: ANDREW WECKMAN MA, LPC-MH, CAC,QMHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC-MH20384	SD

General Provider Information

NPI Number	:	1700322344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW WECKMAN MA, LPC-MH, CAC,QMHP

Provider Business Mailing Address
First Line	:	225 E 11TH ST STE 215
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57104-6482
Country	:	US
Telephone Number	:	605-777-1942
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 E 11TH ST STE 215
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57104-6482
Country	:	US
Telephone Number	:	605-777-1942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	02/27/2023

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