Provider Demographics
NPI:1194973024
Name:WEISS, LINDSAY BETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:BETH
Last Name:WEISS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:BETH
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:372 SQUIRE RD
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4318
Mailing Address - Country:US
Mailing Address - Phone:781-718-8368
Mailing Address - Fax:
Practice Address - Street 1:372 SQUIRE RD
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4318
Practice Address - Country:US
Practice Address - Phone:781-718-8368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily