Kathryn Jo Weaver, LCSW & LAT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-579 Issued in WY

Practice address

101 N Coronado Dr Ste a
Sierra Vista, AZ 85635-6359

Phone

(520) 343-2940

NPI assigned

Apr 13, 2010

Last updated

Aug 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1114243342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NAVAJO TRL",
            "city": "BISBEE",
            "state": "AZ",
            "postal_code": "856031639",
            "telephone_number": "307-752-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N CORONADO DR STE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856356359",
            "telephone_number": "520-343-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KATHRYN",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "LCSW & LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "LAT-305",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Paul Wayne, CRNA
• Weathered Reins Therapy LLC
• Kelsey Webb
• Michael Olan Webb, M.S., CCC-A
• Thomas Weeks III, RPH
• Jena L Wehrle, PSY.S.
• Kevin Welker, D.O.

• Clinical Social Worker in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.