Provider Demographics
NPI:1013656016
Name:WEBER, ANNMARIE KATHLEEN (LMSW)
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:KATHLEEN
Last Name:WEBER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANNMARIE
Other - Middle Name:KATHLEEN
Other - Last Name:ANDERSSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:31 SUMMERTIME TRL
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-9187
Mailing Address - Country:US
Mailing Address - Phone:585-944-8134
Mailing Address - Fax:
Practice Address - Street 1:6539 ANTHONY DR STE A
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1441
Practice Address - Country:US
Practice Address - Phone:585-398-8835
Practice Address - Fax:585-398-7376
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0928161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY092816OtherNEW YORK STATE OFFICE OF THE PROFESSIONS - LMSW