Healthcare Provider Details

I. General information

NPI: 1407762776
Provider Name (Legal Business Name): LA WEIMAN, LPC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22600 HALL RD STE 201
CLINTON TOWNSHIP MI
48036-1173
US

IV. Provider business mailing address

53088 CHAMPLAIN ST
MACOMB MI
48042-3738
US

V. Phone/Fax

Practice location:
  • Phone: 586-496-4503
  • Fax:
Mailing address:
  • Phone: 586-332-5043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: LORI A WEIMAN
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 586-332-5043