Provider Demographics
NPI:1013265891
Name:WEILLER, CAREY RICHARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CAREY
Middle Name:RICHARD
Last Name:WEILLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 BURNHAM AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2526
Mailing Address - Country:US
Mailing Address - Phone:702-249-2341
Mailing Address - Fax:
Practice Address - Street 1:3195 BURNHAM AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2526
Practice Address - Country:US
Practice Address - Phone:702-249-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6322-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical