Active NPI
Kelly Jean Weaver, MED, EDS, LPC
- Professional Counselor
- Lexington, SC
National Provider Identifier
1063594034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2760
- Practice address
- 224 E Main St
Lexington, SC 29072-3546 - Phone
- (803) 808-5222
- Fax
- (803) 957-2042
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2760 | SC | Primary |
Addresses
Primary practice location
224 E Main St
Lexington, SC 29072-3546
Mailing address
224 E Main St
Lexington, SC 29072-3546
Phone (803) 808-5222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 5, 2025 through Aug 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2760 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063594034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 E MAIN ST",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290723546",
"telephone_number": "803-808-5222",
"fax_number": "803-957-2042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 E MAIN ST",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290723546",
"telephone_number": "803-808-5222",
"fax_number": "803-957-2042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "KELLY",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "MED, EDS, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "2760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.