Provider Demographics
NPI:1467057570
Name:WEED, ERIC A (CDCA, CT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:A
Last Name:WEED
Suffix:
Gender:M
Credentials:CDCA, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22639 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1622
Mailing Address - Country:US
Mailing Address - Phone:216-404-1900
Mailing Address - Fax:
Practice Address - Street 1:22639 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1622
Practice Address - Country:US
Practice Address - Phone:216-404-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175161324500000X
OHC.2103668-TRNE390200000X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program