Provider Demographics
NPI:1316099252
Name:WEILAND, SAMUEL PULLIAM JR (LMFT)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:PULLIAM
Last Name:WEILAND
Suffix:JR
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681674
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1674
Mailing Address - Country:US
Mailing Address - Phone:615-330-3614
Mailing Address - Fax:615-591-2741
Practice Address - Street 1:357 RIVERSIDE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-8963
Practice Address - Country:US
Practice Address - Phone:615-330-3614
Practice Address - Fax:615-591-2741
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLMT243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist