Provider Demographics
NPI:1851631386
Name:WEILAND, JEREMIAH DAVID (LPC)
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:DAVID
Last Name:WEILAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5029 MEADOWRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8235
Mailing Address - Country:US
Mailing Address - Phone:412-224-9585
Mailing Address - Fax:
Practice Address - Street 1:5029 MEADOWRIDGE LN
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-8235
Practice Address - Country:US
Practice Address - Phone:412-224-9585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional