Healthcare Provider Details

I. General information

NPI: 1285998252
Provider Name (Legal Business Name): DON CLAIR WEIR III MA, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 DEER TRACKS TRL SUITE, 260
SAINT LOUIS MO
63131-1839
US

IV. Provider business mailing address

1715 DEER TRACKS TRL SUITE, 260
SAINT LOUIS MO
63131-1839
US

V. Phone/Fax

Practice location:
  • Phone: 314-495-0302
  • Fax:
Mailing address:
  • Phone: 314-495-0302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2013029339
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: