Provider Demographics
NPI:1740437482
Name:WEAVER, KIRK A (LCPC, LCAC)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:A
Last Name:WEAVER
Suffix:
Gender:M
Credentials:LCPC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 EAST ELM
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:785-825-6224
Mailing Address - Fax:785-825-7595
Practice Address - Street 1:617 EAST ELM
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-825-6224
Practice Address - Fax:785-825-7595
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCPC 0141101YM0800X
KSLCAC 0114101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health