Provider Demographics
NPI:1790062677
Name:WEINER, ELIZABETH EVE (LCPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EVE
Last Name:WEINER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:ERLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11615 SILVER MAPLE COURT
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030
Mailing Address - Country:US
Mailing Address - Phone:443-440-2293
Mailing Address - Fax:410-664-0115
Practice Address - Street 1:5750 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3930
Practice Address - Country:US
Practice Address - Phone:410-843-7366
Practice Address - Fax:410-664-0115
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4050101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional