Provider Demographics
NPI:1962655951
Name:WEISS, LOIS ANN
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:ANN
Last Name:WEISS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:ANN
Other - Last Name:ELAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:4221 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-1015
Mailing Address - Country:US
Mailing Address - Phone:765-282-7150
Mailing Address - Fax:
Practice Address - Street 1:4221 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-1015
Practice Address - Country:US
Practice Address - Phone:765-282-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001396A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health