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General NPI Number Information
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NPI Number | 1528337128
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Entity Type | Individual
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Provider Name | CORIE BRANNON WEATHERS LPC
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Gender | Female
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Dates
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Enumeration Date | 12/28/2011
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Last Update Date | 08/13/2023
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Provider Practice Location Address
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Address Line | 5553 PERDITA DR
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City | BELTON
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State | TX
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Zip | 76513-5878
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Country | US
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Telephone | 719-439-3693
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Fax |
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Provider Business Mailing Address
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Address Line | 5553 PERDITA DR
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City | BELTON
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State | TX
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Zip | 76513-5878
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Country | US
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Telephone | 719-439-3693
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC006684
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC5674
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006789
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 83152
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License Number State | TX
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