Provider Demographics
NPI:1245494582
Name:WEAVER, DEANNE (DEE) K (LMHP)
Entity type:Individual
Prefix:MS
First Name:DEANNE (DEE)
Middle Name:K
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-1744
Mailing Address - Country:US
Mailing Address - Phone:308-529-1040
Mailing Address - Fax:
Practice Address - Street 1:1303 LAKE AVE
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138-1744
Practice Address - Country:US
Practice Address - Phone:308-529-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4261101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health