Provider Demographics
NPI:1629316591
Name:WEBER, LINFORD (LSW)
Entity Type:Individual
Prefix:
First Name:LINFORD
Middle Name:
Last Name:WEBER
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 HOCH RD
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-8538
Mailing Address - Country:US
Mailing Address - Phone:484-225-9200
Mailing Address - Fax:
Practice Address - Street 1:270 HOCH RD
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-8538
Practice Address - Country:US
Practice Address - Phone:484-225-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125761104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker