Provider Demographics
NPI:1609296078
Name:LAURIE A. WEISS-BRAUNSTEIN, LCSW,LLC
Entity Type:Organization
Organization Name:LAURIE A. WEISS-BRAUNSTEIN, LCSW,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEISS-BRAUNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-447-8056
Mailing Address - Street 1:14345 BROOKMERE DR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-4106
Mailing Address - Country:US
Mailing Address - Phone:703-447-8056
Mailing Address - Fax:703-993-8631
Practice Address - Street 1:5675 STONE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1667
Practice Address - Country:US
Practice Address - Phone:703-447-8056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904004475251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health