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NPI Code Detail

MEDICARE: MICHELLE LEIGH WEAVER LMSW, CSW INTERN

MEDICARE:   MICHELLE LEIGH WEAVER  LMSW, CSW INTERN
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
1172V00000XCommunity Health Worker
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1457772741
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE LEIGH WEAVER LMSW, CSW INTERN
Provider Business Mailing Address
First Line : 4029 DEAN MARTIN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4138
Country : US
Telephone Number : 702-623-2485
Fax Number :
Provider Business Practice Location Address
First Line : 4029 DEAN MARTIN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4138
Country : US
Telephone Number : 702-623-2485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2014
Last Update Date : 10/22/2024

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Directions to “ MICHELLE LEIGH WEAVER LMSW, CSW INTERN” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.