Provider Demographics
NPI:1053583757
Name:WEISS, GARY DAVID (MC, LPC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:DAVID
Last Name:WEISS
Suffix:
Gender:M
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 FORBES AVE STE 900
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3326
Mailing Address - Country:US
Mailing Address - Phone:412-246-5247
Mailing Address - Fax:412-246-5858
Practice Address - Street 1:3501 FORBES AVE STE 900
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3326
Practice Address - Country:US
Practice Address - Phone:412-246-5247
Practice Address - Fax:412-246-5858
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional