KEVIN WEAVER (NPI# 1376073189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376073189 |
| Entity Type | Individual |
| Full Name | KEVIN WEAVER |
| Practice Address |
775 South Bonner Street Ruston LA 71270 |
| Mailing Address |
775 S Bonner St Ruston LA 71270-5801 |
| Practice Telephone | (318) 254-7050 |
| Practice Fax Number | 3182547053 |
| Mailing Telephone | 3182547050 |
| Mailing Fax Number | 3182547053 |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NEW HORIZON COUNSELING AGENCY | 1396055273 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225492929 | Kevin Weaver Jr. | Pediatrics | #1 Children's Way, Slot Ach 512-19a, Little Rock, AR 72202 | 2016-04-08 |
| 1457750051 | Kevin Weaver | Counselor | 846 W 35th St, Norfolk, VA 23508-3011 | 2014-08-19 |
| 1174657134 | Kevin Weaver | Psychologist | 1001 E Griswold Rd Unit 20, Phoenix, AZ 85020-3777 | 2007-03-14 |
| 1851475974 | Kevin C Weaver | Physical Therapist | 12 E 97th St # 1c, New York, NY 10029-6918 | 2006-10-25 |
| 1154711596 | Kevin Weaver | Nurse Practitioner | 4201 Campus Ridge Dr Ste 3100, Midland, MI 48640-6135 | 2015-01-23 |
| 1043585128 | Kevin Weaver | Social Worker | 3415 Se Powell Blvd, Portland, OR 97202-3371 | 2012-03-21 |
| 1154353811 | Kevin Weaver | Emergency Medicine | 1200 S Cedar Crest Blvd, Allentown, PA 18103-6202 | 2006-07-06 |
| 1487693784 | Kevin L. Weaver | Specialist | 6606 Lbj Fwy, Suite 200, Dallas, TX 75240-6533 | 2006-06-05 |
| 1447244009 | Kevin M Weaver | Family Medicine | 555 Herndon Pkwy, Ste 100, Herndon, VA 20170-5276 | 2005-09-09 |
| Street Address |
775 SOUTH BONNER STREET |
| City | RUSTON |
| State | LA |
| Zip Code | 71270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123289 | Shayla Jackson | Counselor | 775 South Bonner Street, Ruston, LA 71270 | 2017-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821315 | Olivia Mason | Marriage & Family Therapist | 413 North Homer Street, Ruston, LA 71270 | 2020-11-04 |
| 1972146132 | Razz Addiction and Recovery, LLC | Family Medicine | 570 Heard Rd, Ruston, LA 71270 | 2019-10-21 |
| 1518435999 | Tenia Holloway | Case Manager/Care Coordinator | 612 Henderson St., F12, Ruston, LA 71270 | 2018-11-05 |
| 1245708718 | A Plus Medical of Ruston LLC | Family Medicine | 612 S Farmerville Street, Ruston, LA 71270 | 2018-11-02 |
| 1255808085 | Amanda M Clark | Specialist/Technologist | 2301 Timberline Ct Apt F105, Ruston, LA 71270 | 2018-10-30 |
| 1912473752 | Lincoln Nova Vital Recovery | Counselor | 4396 Hwy, 80, 617 South Trention, Ruston, LA 71270 | 2018-10-19 |
| 1861975237 | Wymeka Andrea Breaux | Case Manager/Care Coordinator | 705 Martin Luther King Dr., Ruston, LA 71270 | 2018-09-12 |
| 1790292001 | Louquyhanta Foster | Case Manager/Care Coordinator | 593 Belton Rd, Ruston, LA 71270 | 2018-01-08 |
| 1609391010 | Chemia Herron | Counselor | 775 S Bonner, Ruston, LA 71270 | 2017-08-07 |
| 1477083517 | Arnesha Beard | Counselor | 775 South Bonner, Ruston, LA 71270 | 2017-06-12 |
| Find all providers in zip 71270 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738790 | Tamara Kay Kabel | Counselor | 5204 N Bennett St Apt 507, Ruston, WA 98407-6500 | 2020-10-25 |
| 1740742956 | Ashley Bre'ann Jacobs | Counselor | 609 S Vienna St, Ruston, LA 71270-5038 | 2019-04-05 |
| 1710467899 | Ashley Elizabeth Owen | Counselor | 285 Jed Rd, Ruston, LA 71270-6998 | 2018-08-17 |
| 1467941492 | Kimberly Sherrell Jolivette | Counselor | 3105 Lafourche Ave, Ruston, LA 71270-5260 | 2018-05-04 |
| 1447758842 | Regan Spivey | Counselor | 114 Nutmeg Dr, Ruston, LA 71270-0101 | 2018-01-31 |
| 1356853998 | James Alphonse Benoit | Counselor | 5010 N Highland St, Ruston, WA 98407-3118 | 2017-11-03 |
| 1609391010 | Chemia Herron | Counselor | 775 S Bonner, Ruston, LA 71270 | 2017-08-07 |
| 1205358108 | Stephanie Denise Young | Counselor | 172 Heard Rd, Ruston, LA 71270-1033 | 2017-07-12 |
| 1659891182 | Keeansia Greenwood | Counselor | 131 Greene Ln, Ruston, LA 71270-8390 | 2017-06-26 |
| 1952831406 | Keanetta Nicole Brown | Counselor | 1408 Tech Farm Rd Apt D12, Ruston, LA 71270-5484 | 2017-06-18 |
| Find all providers in RUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.