Weisbender, Mark Alan
Weisbender, Mark Alan is an sole proprietor health care provider with primary practice located at 3195 S Main St Ste 180 , South Salt Lake UT 84115-3790. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Weisbender, Mark Alan can be contacted via phone (801) 983-5540.Contact Information
Primary practice address
3195 S Main St Ste 180
South Salt Lake UT 84115-3790
Phone: (801) 983-5540
Fax: (801) 983-5542
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 263270-3501 | Utah |
Profile Details
| NPI number | 1487616330 |
|---|---|
| LBN Legal business name | Weisbender, Mark Alan |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Aug 4th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487616330 | NPPES |
| Utah | MEDICAID | 788007788802 |
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