Healthcare Provider Details

I. General information

NPI: 1447177308
Provider Name (Legal Business Name): AKISHA ROCHELLE WEATHERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 DUNKIRK AVE
NORFOLK VA
23509-1813
US

IV. Provider business mailing address

2911 DUNKIRK AVE
NORFOLK VA
23509-1813
US

V. Phone/Fax

Practice location:
  • Phone: 757-406-2306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704017938
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: