Provider Demographics
NPI:1114389558
Name:WEIMER, CAROLYN JANE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JANE
Last Name:WEIMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:JANE
Other - Last Name:EWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:830 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233-1716
Mailing Address - Country:US
Mailing Address - Phone:412-322-2129
Mailing Address - Fax:
Practice Address - Street 1:239 4TH AVE STE 1801
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1716
Practice Address - Country:US
Practice Address - Phone:412-532-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2023-04-25
Deactivation Date:2019-07-19
Deactivation Code:
Reactivation Date:2019-07-26
Provider Licenses
StateLicense IDTaxonomies
PAPC007594101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC007594OtherCOMMONWEALTH OF PENNSYLVANIA