Individual
JASON CODY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
37 S 40TH ST, PHILADELPHIA, PA 19104
(215) 444-7470
Mailing address
PO BOX 746722, ATLANTA, GA 30374-6722
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C008993
NC
1041C0700X
Clinical Social Worker
Primary
CW020434
PA
Other
Enumeration date
05/22/2012
Last updated
09/10/2020
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