Healthcare Provider Details

I. General information

NPI: 1497665343
Provider Name (Legal Business Name): MICHELLE WEAVER LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 S BROAD ST STE 7
BREVARD NC
28712-2207
US

IV. Provider business mailing address

520 FISHER RD
BREVARD NC
28712-0678
US

V. Phone/Fax

Practice location:
  • Phone: 828-222-0590
  • Fax:
Mailing address:
  • Phone: 828-222-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: