MEDICARE: JERRY WEASE LCAS

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	10607	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	2456	NC

General Provider Information

NPI Number	:	1225373665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERRY WEASE LCAS

Provider Business Mailing Address
First Line	:	314 US HIGHWAY 221A
Second Line	:
City	:	FOREST CITY
State	:	NC
Zip	:	28043-5902
Country	:	US
Telephone Number	:	828-202-3075
Fax Number	:

Provider Business Practice Location Address
First Line	:	271 CALLAHAN KOON RD
Second Line	:
City	:	SPINDALE
State	:	NC
Zip	:	28160-2207
Country	:	US
Telephone Number	:	828-288-8773
Fax Number	:	828-288-9577

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

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	03/02/2026

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1972523504 — CYNTHIA A GARLAND LPA
Practice Location Address:

271-A CALLAHAN KOON RD
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1528081387 — MRS. SUSAN L CARRIER LCAS CSAC
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1285791087 — FOOTHILLS HEALTH DISTRICT
Practice Location Address:

221 CALLAHAN KOON RD
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1578682837 — KERRY SHAWN REDMOND LCAS
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271A CALLAHAN KOON RD
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Directions to “ JERRY WEASE LCAS” Practice Location

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