Provider Demographics
NPI:1215308275
Name:WEINBERG, ARI (PSYD)
Entity type:Individual
Prefix:
First Name:ARI
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 ASHLAND STREET
Mailing Address - Street 2:SUITE C #460
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3777
Mailing Address - Country:US
Mailing Address - Phone:541-631-6151
Mailing Address - Fax:
Practice Address - Street 1:149 CLEAR CREEK DR UNIT 111
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1882
Practice Address - Country:US
Practice Address - Phone:541-631-6151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2705103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist