Provider Demographics
NPI:1215227400
Name:WEISS-BRAUNSTEIN, LAURIE ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:ANN
Last Name:WEISS-BRAUNSTEIN
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 1:10900 UNIVERSITY BLVD, BULL RUN HALL
Mailing Address - Street 2:SUITE 147
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-2201
Mailing Address - Country:US
Mailing Address - Phone:703-447-8056
Mailing Address - Fax:703-993-8631
Practice Address - Street 1:10900 UNIVERSITY BLVD
Practice Address - Street 2:BULL RUN HALL, SUITE 147
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-2201
Practice Address - Country:US
Practice Address - Phone:703-447-8056
Practice Address - Fax:703-993-8631
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-09
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040044751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical