Provider Demographics
NPI:1922749357
Name:WEILER, LEE ANN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:LEE ANN
Middle Name:
Last Name:WEILER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 S VAL VISTA DR UNIT 70
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-3264
Mailing Address - Country:US
Mailing Address - Phone:480-388-0822
Mailing Address - Fax:
Practice Address - Street 1:3920 S RURAL RD STE 112
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5500
Practice Address - Country:US
Practice Address - Phone:480-428-2944
Practice Address - Fax:480-680-5361
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional