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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487616330 NPPES
Utah MEDICAID 788007788802

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