Provider Demographics
NPI:1730560400
Name:WEBER, KARIN ELISE (LCSW)
Entity type:Individual
Prefix:MS
First Name:KARIN
Middle Name:ELISE
Last Name:WEBER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3454 MILDRED DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3910
Mailing Address - Country:US
Mailing Address - Phone:703-309-3803
Mailing Address - Fax:
Practice Address - Street 1:4000 GENESEE PL
Practice Address - Street 2:SUITE 109
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8302
Practice Address - Country:US
Practice Address - Phone:703-309-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904008807101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health