Provider Demographics
NPI:1477980670
Name:WEAVER, MARCI LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:LYNN
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5084 VIRGINIA PINE RD
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-1121
Mailing Address - Country:US
Mailing Address - Phone:423-320-4198
Mailing Address - Fax:
Practice Address - Street 1:1807 TAFT HWY STE 6
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-3527
Practice Address - Country:US
Practice Address - Phone:423-414-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2023-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW68331041C0700X
AR7067-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5EE84OtherBCBS
AR7067-COtherBCBS
AR5EE84OtherBCBS