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NPI Code Detail

MEDICARE: MARIA WEAVER LPC

MEDICARE: MARIA WEAVER LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor0701008268VA

General Provider Information

NPI Number : 1164678330
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA WEAVER LPC
Provider Business Mailing Address
First Line : 718 J CLYDE MORRIS BLVD STE D
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-1540
Country : US
Telephone Number : 757-690-0741
Fax Number : 757-595-1885
Provider Business Practice Location Address
First Line : 718 J CLYDE MORRIS BLVD STE D
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-1540
Country : US
Telephone Number : 757-690-0741
Fax Number : 757-595-1885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2008
Last Update Date : 05/17/2019

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Directions to “ MARIA WEAVER LPC” Practice Location

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