Provider Demographics
NPI:1083966287
Name:WEICHHAND, GREGORY ANDREW JR (LLP, LPC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ANDREW
Last Name:WEICHHAND
Suffix:JR
Gender:M
Credentials:LLP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 OSWEGO ST NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-6046
Mailing Address - Country:US
Mailing Address - Phone:616-915-8400
Mailing Address - Fax:
Practice Address - Street 1:2716 E PARIS AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6139
Practice Address - Country:US
Practice Address - Phone:616-975-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional