Provider Demographics
NPI:1992411722
Name:WEAKS, CLARA CHRISTINE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:CHRISTINE
Last Name:WEAKS
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:
Other - Last Name:DREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:360 GRAN VIA APT 3104
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-0123
Mailing Address - Country:US
Mailing Address - Phone:972-965-6503
Mailing Address - Fax:
Practice Address - Street 1:431 E STATE HIGHWAY 114 FL 1
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4412
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional