Provider Demographics
NPI:1831909563
Name:WEIBE, KRISTEN ANGELICA (LCMHCA)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANGELICA
Last Name:WEIBE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 BLUE RIBBON LN
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-7535
Mailing Address - Country:US
Mailing Address - Phone:910-627-6312
Mailing Address - Fax:
Practice Address - Street 1:2005 HOPE MILLS RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4224
Practice Address - Country:US
Practice Address - Phone:910-635-1685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20590101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor