Provider Demographics
NPI:1801977962
Name:WEISS, LESTER IRWIN (LCSW)
Entity type:Individual
Prefix:MR
First Name:LESTER
Middle Name:IRWIN
Last Name:WEISS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 2ND ST N STE 7
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-3503
Mailing Address - Country:US
Mailing Address - Phone:727-725-8820
Mailing Address - Fax:727-725-8361
Practice Address - Street 1:801 2ND ST N STE 7
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3503
Practice Address - Country:US
Practice Address - Phone:727-725-8820
Practice Address - Fax:727-725-8361
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6181101YA0400X
PACW0128301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS17915Medicare ID - Type Unspecified