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General NPI Number Information
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NPI Number | 1487541827
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Entity Type | Individual
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Provider Name | HEATHER LYNN WEAVER-FARIAS
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Gender | Female
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 222 BEAUREGARD BLVD
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City | CHARLES TOWN
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State | WV
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Zip | 25414-3846
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Country | US
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Telephone | 304-671-8687
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MERIDIAN PARKWAY, SUITE 107
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City | MARTINSBURG
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State | WV
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Zip | 25404
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Country | US
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Telephone | 304-671-4875
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Fax | 304-441-5636
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | DP00946345
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License Number State | WV
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