Provider Demographics
NPI:1053889055
Name:WEBER, ABIGAIL (LPC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10023 N FOXKIRK DR
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53097-3619
Mailing Address - Country:US
Mailing Address - Phone:414-202-3962
Mailing Address - Fax:
Practice Address - Street 1:8440 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-1734
Practice Address - Country:US
Practice Address - Phone:414-405-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7163-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional