MEDICARE: DR. RICHARD HERBERT WEISBERG PSY.D.

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	103TC0700X	Clinical Psychologist	5361	OH

General Provider Information

NPI Number	:	1750356267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD HERBERT WEISBERG PSY.D.

Provider Business Mailing Address
First Line	:	8984 DARROW RD STE 2-145
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-2186
Country	:	US
Telephone Number	:	216-291-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	8984 DARROW RD STE 2-145
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-2186
Country	:	US
Telephone Number	:	216-291-1010
Fax Number	:

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

Provider Enumeration Date	:	02/18/2006
Last Update Date	:	01/22/2022

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