Provider Demographics
NPI:1710143136
Name:WEAL, DAVID L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:WEAL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WASHINGTON ST
Mailing Address - Street 2:SUITE 510
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3330
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 WASHINGTON ST
Practice Address - Street 2:SUITE 510
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3330
Practice Address - Country:US
Practice Address - Phone:315-782-4483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055373101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor