MEDICARE: MR. MARK W WEINER LPC ,LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701000876	VA
2	106H00000X	Marriage & Family Therapist	0717000082	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184643009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK W WEINER LPC ,LMFT

Provider Business Mailing Address
First Line	:	3108 N PARHAM RD STE 200A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4420
Country	:	US
Telephone Number	:	804-346-0870
Fax Number	:	804-290-0474

Provider Business Practice Location Address
First Line	:	3108 N PARHAM RD STE 200A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4420
Country	:	US
Telephone Number	:	804-346-0870
Fax Number	:	804-290-0474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	09/11/2025

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