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Provider Information for 1336162213


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Ms. CHERRY LOUISE WEAVER


Other Names:  
Former Name: 
Ms. CHERRY LOUISE SHAFFER LPC

Sex: Female

NPI: 1336162213
Last Updated: 2012-01-24
Certification Date:

Details

NameValue
NPI1336162213
Enumeration Date2006-07-25
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 7706 WATER FOWL TRL
ARLINGTON, TX 76002-4571
United States

Phone: 817-247-0880 | Fax:817-626-6400
 
Primary Practice Address 111 NW 24TH ST
FORT WORTH, TX 76164-8544
United States

Phone: 817-626-7640 | Fax:817-626-6400
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)TX1660
Yes 101YP2500X - Counselor - ProfessionalTX18833