Provider Demographics
NPI:1700322344
Name:WECKMAN, ANDREW (MA, LPC-MH, CAC,QMHP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:WECKMAN
Suffix:
Gender:M
Credentials:MA, LPC-MH, CAC,QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 11TH ST STE 215
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-6482
Mailing Address - Country:US
Mailing Address - Phone:605-777-1942
Mailing Address - Fax:
Practice Address - Street 1:225 E 11TH ST STE 215
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6482
Practice Address - Country:US
Practice Address - Phone:605-777-1942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH20384101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health