Individual
CHARLES COULTER WEAVER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LMFT
Contact information
Practice address
2924 KING ST, ALEXANDRIA, VA 22302-3512
(703) 475-2221
(703) 684-3407
Mailing address
5616I OX RD UNIT 194, FAIRFAX STATION, VA 22039-8014
(703) 475-2221
(703) 684-3407
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701001741
VA
106H00000X
Marriage & Family Therapist
Primary
0717000869
VA
Other
Enumeration date
08/08/2014
Last updated
09/02/2022
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