Provider Demographics
NPI:1285389957
Name:WEAVER, ROBIN MARIE (MA, NCC, LCMHCA)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARIE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MA, NCC, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-3703
Mailing Address - Country:US
Mailing Address - Phone:864-491-9864
Mailing Address - Fax:
Practice Address - Street 1:621A S LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-5807
Practice Address - Country:US
Practice Address - Phone:704-692-0723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health