Provider Demographics
NPI:1073295606
Name:WEISS, ERIN (LGSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 OATES ST NE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3823
Mailing Address - Country:US
Mailing Address - Phone:817-994-2619
Mailing Address - Fax:
Practice Address - Street 1:405 SHERIDAN ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1406
Practice Address - Country:US
Practice Address - Phone:202-671-0693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG200002381101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor