Provider Demographics
NPI:1952922809
Name:WEAKLEY, JAMES (LPC/MHSP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:WEAKLEY
Suffix:
Gender:M
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 CARL WHITTEN RD
Mailing Address - Street 2:
Mailing Address - City:HORNSBY
Mailing Address - State:TN
Mailing Address - Zip Code:38044-2039
Mailing Address - Country:US
Mailing Address - Phone:731-434-9224
Mailing Address - Fax:
Practice Address - Street 1:335 CARL WHITTEN RD
Practice Address - Street 2:
Practice Address - City:HORNSBY
Practice Address - State:TN
Practice Address - Zip Code:38044-2039
Practice Address - Country:US
Practice Address - Phone:731-434-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5070101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional