Provider Demographics
NPI:1013263714
Name:WEAKS, RICH A (MA, LLPC)
Entity type:Individual
Prefix:MR
First Name:RICH
Middle Name:A
Last Name:WEAKS
Suffix:
Gender:M
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 WOLVERINE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1654
Mailing Address - Country:US
Mailing Address - Phone:734-735-1942
Mailing Address - Fax:
Practice Address - Street 1:623 WOLVERINE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-1654
Practice Address - Country:US
Practice Address - Phone:734-735-1942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2238243101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)