Provider Demographics
NPI:1427076579
Name:WEAVER, LINDSAY LITTELL (LPC)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:LITTELL
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:LITTELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:112 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-7408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:318 TURNERSBURG HWY
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-2798
Practice Address - Country:US
Practice Address - Phone:704-402-1060
Practice Address - Fax:704-402-1065
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103010Medicaid