Provider Demographics
NPI:1821680745
Name:WEISHAR, CHARITY NOEL (LSW)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:NOEL
Last Name:WEISHAR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 WALLENS PL
Mailing Address - Street 2:
Mailing Address - City:BLACK HAWK
Mailing Address - State:CO
Mailing Address - Zip Code:80422-4200
Mailing Address - Country:US
Mailing Address - Phone:773-301-2947
Mailing Address - Fax:
Practice Address - Street 1:53 WALLENS PL
Practice Address - Street 2:
Practice Address - City:BLACK HAWK
Practice Address - State:CO
Practice Address - Zip Code:80422-4200
Practice Address - Country:US
Practice Address - Phone:773-301-2947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009924453104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker