Provider Demographics
NPI:1518796473
Name:WEAVER, JOSEPH (LMSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:WEAVER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-3658
Mailing Address - Country:US
Mailing Address - Phone:347-394-5923
Mailing Address - Fax:
Practice Address - Street 1:18 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3658
Practice Address - Country:US
Practice Address - Phone:347-394-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical