Provider Demographics
NPI:1548084841
Name:WEBER, DEE ANNE (LGPC)
Entity type:Individual
Prefix:
First Name:DEE
Middle Name:ANNE
Last Name:WEBER
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KALTEN RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-3036
Mailing Address - Country:US
Mailing Address - Phone:410-903-1564
Mailing Address - Fax:
Practice Address - Street 1:MAIN STREET BEHAVIORAL HEALTH
Practice Address - Street 2:37 MAIN STREET
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136
Practice Address - Country:US
Practice Address - Phone:410-526-7882
Practice Address - Fax:410-525-9855
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
MDLGP15747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)