Provider Demographics
NPI:1285905331
Name:WEISS, ALEXANDER E (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:E
Last Name:WEISS
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 N HIGHWAY 97 STE 100
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-7559
Mailing Address - Country:US
Mailing Address - Phone:541-419-6958
Mailing Address - Fax:541-600-4731
Practice Address - Street 1:2955 N HIGHWAY 97 STE 100
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7559
Practice Address - Country:US
Practice Address - Phone:541-419-6958
Practice Address - Fax:541-600-4731
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC2790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional