Provider Demographics
NPI:1881056463
Name:WEBER-WOODS, EVELYN (MA)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:
Last Name:WEBER-WOODS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16824 BLACK KETTLE DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3301
Mailing Address - Country:US
Mailing Address - Phone:201-953-0276
Mailing Address - Fax:
Practice Address - Street 1:16824 BLACK KETTLE DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3301
Practice Address - Country:US
Practice Address - Phone:201-953-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80590101YM0800X
WALH61334190101YM0800X
NJ37AC00146600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health