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NPI Code Detail

MEDICARE: MR. RICHARD CARLTON WEAVER MA, LPC, NCC, CBIS,

MEDICARE:  MR. RICHARD CARLTON WEAVER  MA, LPC, NCC, CBIS,
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
1101YP2500XProfessional Counselor6401012674MI

General Provider Information

NPI Number : 1548684715
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD CARLTON WEAVER MA, LPC, NCC, CBIS,
Provider Business Mailing Address
First Line : 5600 W MAPLE RD STE D401
Second Line :
City : WEST BLOOMFIELD
State : MI
Zip : 48322-3711
Country : US
Telephone Number : 248-881-0944
Fax Number : 248-851-7607
Provider Business Practice Location Address
First Line : 5600 W MAPLE RD STE D401
Second Line :
City : WEST BLOOMFIELD
State : MI
Zip : 48322-3711
Country : US
Telephone Number : 248-881-0944
Fax Number : 248-851-7607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2014
Last Update Date : 02/09/2014

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Directions to “ MR. RICHARD CARLTON WEAVER MA, LPC, NCC, CBIS,” Practice Location

Language Start Address Practice Location
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.