Provider Demographics
NPI:1982863643
Name:WEAVER, CASEY J (LMFT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:J
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:A
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:925 N FAIRFAX ST APT 1104
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5553
Mailing Address - Country:US
Mailing Address - Phone:608-347-3144
Mailing Address - Fax:608-252-1328
Practice Address - Street 1:925 N FAIRFAX ST APT 1104
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5553
Practice Address - Country:US
Practice Address - Phone:608-347-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717002013106H00000X
WI785-124106H00000X
TX203156106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist