Provider Demographics
NPI:1659416782
Name:WEISS, JOAN C, (MSW, LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:C,
Last Name:WEISS
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14912 CLAVEL ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1545
Mailing Address - Country:US
Mailing Address - Phone:301-460-4457
Mailing Address - Fax:301-460-7666
Practice Address - Street 1:14912 CLAVEL ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-1545
Practice Address - Country:US
Practice Address - Phone:301-460-4457
Practice Address - Fax:301-460-7666
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD039901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical