Provider Demographics
NPI:1477624500
Name:WEAVER, LOUISE DUGAN (LCSW-C)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:DUGAN
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MS
Other - First Name:LOUISE
Other - Middle Name:DEYERBERG
Other - Last Name:DUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, MED
Mailing Address - Street 1:3102 LANDFALL LN
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-4312
Mailing Address - Country:US
Mailing Address - Phone:301-641-9057
Mailing Address - Fax:443-949-8889
Practice Address - Street 1:1831 FOREST DR STE B
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4430
Practice Address - Country:US
Practice Address - Phone:301-641-9057
Practice Address - Fax:443-949-8889
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD048951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical