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Individual

JOHNATHAN HAYES WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC, LSATP

Contact information

Practice address
2530 PROFESSIONAL RD STE 201, NORTH CHESTERFIELD, VA 23235-3217
(804) 658-6760
(804) 658-7195
Mailing address
PO BOX 38031, HENRICO, VA 23231-0831
(804) 252-3958

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000640
VA
101YP2500X
Professional Counselor
Primary
0701008852
VA

Other

Enumeration date
12/30/2019
Last updated
10/28/2024
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