Provider Demographics
NPI:1780808337
Name:WESTON, E VIGINIA (LMHP, RN)
Entity type:Individual
Prefix:
First Name:E
Middle Name:VIGINIA
Last Name:WESTON
Suffix:
Gender:F
Credentials:LMHP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 641130
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7130
Mailing Address - Country:US
Mailing Address - Phone:402-572-2907
Mailing Address - Fax:402-572-3544
Practice Address - Street 1:1309 HARLAN DR
Practice Address - Street 2:SUITE 206
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-6604
Practice Address - Country:US
Practice Address - Phone:402-291-6789
Practice Address - Fax:402-291-8806
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health