Basic Information
| Provider Information | |||||||||
| NPI: | 1649528837 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEAVER | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | FAITH QUASIUS | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MSW | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | QUASIUS | ||||||||
| OtherFirstName: | LINDSAY | ||||||||
| OtherMiddleName: | FAITH | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4203 WOODCOCK DR | ||||||||
| Address2: | STE 216 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782281312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105649116 | ||||||||
| FaxNumber: | 2105649087 | ||||||||
| Practice Location | |||||||||
| Address1: | 1109 E 139TH AVE | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336133420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139722289 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2012 | ||||||||
| LastUpdateDate: | 05/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.