Provider Demographics
NPI:1205054996
Name:WEIPERT, CAROL ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:WEIPERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11991 COUNTY ROAD 438
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64505-3707
Mailing Address - Country:US
Mailing Address - Phone:816-233-4282
Mailing Address - Fax:
Practice Address - Street 1:902 EDMOND ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-2702
Practice Address - Country:US
Practice Address - Phone:816-232-2885
Practice Address - Fax:816-232-2607
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0040861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical