Provider Demographics
NPI:1205026754
Name:WEISBORD, YEHUDA (LCPC)
Entity Type:Individual
Prefix:MR
First Name:YEHUDA
Middle Name:
Last Name:WEISBORD
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HAMMERSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1766
Mailing Address - Country:US
Mailing Address - Phone:410-484-6604
Mailing Address - Fax:410-581-9937
Practice Address - Street 1:800 HAMMERSHIRE RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-1766
Practice Address - Country:US
Practice Address - Phone:410-484-6604
Practice Address - Fax:410-581-9937
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1670101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health