Provider Demographics
NPI:1730179573
Name:WEITZMAN, LYNDA R (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:R
Last Name:WEITZMAN
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 1:102 TALL OAKS DR APT 1B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-3025
Mailing Address - Country:US
Mailing Address - Phone:954-655-4788
Mailing Address - Fax:336-617-8466
Practice Address - Street 1:102 TALL OAKS DR APT 1B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-3025
Practice Address - Country:US
Practice Address - Phone:954-655-4788
Practice Address - Fax:336-617-8466
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0059691041C0700X
FLSW120041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical