1346650660 NPI number — MRS. TRISHA N WEAVER M.ED., LPC, LBS

Table of content: MRS. TRISHA N WEAVER M.ED., LPC, LBS (NPI 1346650660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346650660 NPI number — MRS. TRISHA N WEAVER M.ED., LPC, LBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEAVER
Provider First Name:
TRISHA
Provider Middle Name:
N
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED., LPC, LBS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PARKER
Provider Other First Name:
TRISHA
Provider Other Middle Name:
N
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346650660
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 HIGHLAND DR
Provider Second Line Business Mailing Address:
PO BOX 597
Provider Business Mailing Address City Name:
MOUNTVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17554-1232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-285-7121
Provider Business Mailing Address Fax Number:
717-285-5302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
790 NEW HOLLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602-2137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-390-0353
Provider Business Practice Location Address Fax Number:
717-390-1812
Provider Enumeration Date:
05/08/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  BH000726 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: PC008892 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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