Provider Demographics
NPI:1538268693
Name:WEISEND, COREY W (LPCC)
Entity type:Individual
Prefix:MR
First Name:COREY
Middle Name:W
Last Name:WEISEND
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 N MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-1978
Mailing Address - Country:US
Mailing Address - Phone:330-966-1007
Mailing Address - Fax:
Practice Address - Street 1:931 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1978
Practice Address - Country:US
Practice Address - Phone:330-966-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC8230101YM0800X
OHE.0008230101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health