Provider Demographics
NPI:1073748661
Name:WEIR, DANA LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:LYNN
Last Name:WEIR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 PEQUANNOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1629
Mailing Address - Country:US
Mailing Address - Phone:201-914-7278
Mailing Address - Fax:
Practice Address - Street 1:179 CAHILL CROSS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1988
Practice Address - Country:US
Practice Address - Phone:973-728-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052634001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical