MEDICARE: MS. VALERIE MARIE WEVERS LPCC

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	101YM0800X	Mental Health Counselor	E0007794	OH

General Provider Information

NPI Number	:	1184698177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VALERIE MARIE WEVERS LPCC

Provider Business Mailing Address
First Line	:	11570 STABLE WATCH CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-1393
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 EXECUTIVE PARK DR
Second Line	:	FAMILY SERVICE SUITE 404
City	:	CINCINNATI
State	:	OH
Zip	:	45241-2089
Country	:	US
Telephone Number	:	513-354-5659
Fax Number	:	513-483-6241

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	07/08/2007

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