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General NPI Number Information
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NPI Number | 1619611423
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Entity Type | Individual
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Provider Name | CIARA WEIR CADC
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Gender | Female
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 919 CHAMBERS BLVD STE D
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City | BARDSTOWN
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State | KY
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Zip | 40004-2574
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Country | US
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Telephone | 606-393-6695
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Fax |
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Provider Business Mailing Address
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Address Line | 134 KENTON DR
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City | BARDSTOWN
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State | KY
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Zip | 40004-2569
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Country | US
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Telephone | 502-373-7129
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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 | 289456
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License Number State | KY
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