Provider Demographics
NPI:1376643494
Name:WEISS-BENOIT, LYNETTE MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:MARIE
Last Name:WEISS-BENOIT
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:PO BOX 1088
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-1088
Mailing Address - Country:US
Mailing Address - Phone:530-798-1076
Mailing Address - Fax:530-478-9589
Practice Address - Street 1:224 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2509
Practice Address - Country:US
Practice Address - Phone:530-798-1076
Practice Address - Fax:530-205-9459
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2019-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA245281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical