Provider Demographics
NPI:1386945145
Name:WEBER, DENISE (LPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SAMUELSON RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1009
Mailing Address - Country:US
Mailing Address - Phone:203-544-6094
Mailing Address - Fax:203-544-6093
Practice Address - Street 1:18 SAMUELSON RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883-1009
Practice Address - Country:US
Practice Address - Phone:203-544-6094
Practice Address - Fax:203-544-6093
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001890101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional