Provider Demographics
NPI:1427467554
Name:STEPHANY WEAVER INC
Entity type:Organization
Organization Name:STEPHANY WEAVER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-244-1379
Mailing Address - Street 1:1444 JASMINE WAY
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-6100
Mailing Address - Country:US
Mailing Address - Phone:727-244-1379
Mailing Address - Fax:
Practice Address - Street 1:1444 JASMINE WAY
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-6100
Practice Address - Country:US
Practice Address - Phone:727-244-1379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-02
Last Update Date:2014-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW86451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty