Provider Demographics
NPI:1689181059
Name:WEGHORN, SHEENA CIARRA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:CIARRA
Last Name:WEGHORN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 NIX BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-7040
Mailing Address - Country:US
Mailing Address - Phone:678-719-1673
Mailing Address - Fax:
Practice Address - Street 1:1445 HAW CREEK CIR E STE 501
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6570
Practice Address - Country:US
Practice Address - Phone:770-415-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-06
Last Update Date:2018-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009905101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional