Provider Demographics
NPI:1821223454
Name:WEAVER, CATHERINE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:HENRIETTA
Other - Middle Name:CATHERINE
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1007 MOPAC CIRCLE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-633-5933
Mailing Address - Fax:
Practice Address - Street 1:1007 MOPAC CIRCLE
Practice Address - Street 2:SUITE 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6807
Practice Address - Country:US
Practice Address - Phone:512-633-5933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional