Individual provider Active NPI

Lynda R Weitzman, LCSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1730179573
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12004 Issued in FL
Practice address
102 Tall Oaks Dr Apt 1B
Greensboro, NC 27455-3025
Phone
(954) 655-4788
Fax
(336) 617-8466
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C005969 NC
Clinical Social Worker 1041C0700X SW12004 FL Primary

Addresses

Primary practice location

102 Tall Oaks Dr Apt 1B
Greensboro, NC 27455-3025

Mailing address

102 Tall Oaks Dr Apt 1B
Greensboro, NC 27455-3025
Phone (954) 655-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100521000517 NC Practitioner - Clinical Social Worker 9234268764 Practice locations: Greensboro, NC
I20160706002542 FL Practitioner - Clinical Social Worker 9234268764 Practice locations: Coconut Creek, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

102 Tall Oaks Dr
Apt 1B
Greensboro, NC 27455-3025
Phone (954) 655-4788

1705 Andros Isle
Apt L1
Coconut Creek, FL 33066-2841
Phone (954) 655-4788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C005969NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Charu Jain PSYD LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1730179573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 TALL OAKS DR APT 1B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274553025",
            "telephone_number": "954-655-4788",
            "fax_number": "336-617-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 TALL OAKS DR APT 1B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274553025",
            "telephone_number": "954-655-4788",
            "fax_number": "336-617-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZMAN",
        "first_name": "LYNDA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005969",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.