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NPI Code Detail

MEDICARE: TERESA WEISBROD LPCC

MEDICARE: TERESA WEISBROD LPCC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLICDC.121102OH
2101YM0800XMental Health CounselorE.0004382-SUPVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770718389
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA WEISBROD LPCC
Provider Business Mailing Address
First Line : 311 ALBERT SABIN WAY
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-2838
Country : US
Telephone Number : 513-558-5801
Fax Number :
Provider Business Practice Location Address
First Line : 311 ALBERT SABIN WAY
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-2838
Country : US
Telephone Number : 513-558-5801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2009
Last Update Date : 12/12/2023

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Directions to “ TERESA WEISBROD LPCC” Practice Location

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