Provider Demographics
NPI:1043652480
Name:WEATHERS, LINDSAY RODGERS (LPCA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:RODGERS
Last Name:WEATHERS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 HUNTSMAN CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-6060
Mailing Address - Country:US
Mailing Address - Phone:704-671-4487
Mailing Address - Fax:704-671-4494
Practice Address - Street 1:621 HUNTSMAN CT
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-6060
Practice Address - Country:US
Practice Address - Phone:704-671-4487
Practice Address - Fax:704-671-4494
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional