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General NPI Number Information
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NPI Number | 1033665385
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Entity Type | Individual
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Provider Name | CHARLES WEEMS LLMSW
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Gender | Male
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | MERIDIAN HEALTH SERVICES 1255 N. OAKLAND BLVD.
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City | WATERFORD
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State | MI
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Zip | 48327
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Country | US
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Telephone | 248-406-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 20140 PINEHURST ST
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City | DETROIT
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State | MI
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Zip | 48221-1060
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Country | US
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Telephone | 313-758-8231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6801099755
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License Number State | MI
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