Jack Weaver Jr., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC03852 Issued in AL

Practice address

701B Gault Ave N
Fort Payne, AL 35967-2627

Phone

(256) 979-1620

NPI assigned

Dec 3, 2013

Last updated

Jul 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Synergy Ministries, Inc.

  dba Synergy Counseling Center

  • Professional Counselor
  • Fort Payne, AL
  • NPI 1942631817
  NPD (past)

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1184055048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701B GAULT AVE N",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672627",
            "telephone_number": "256-979-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701B GAULT AVE N",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359672627",
            "telephone_number": "256-979-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-03",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "LPC03852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walker & Isbell Surgeons PA
• Washington and Washington Counseling
• Courtney Lee Washington, DPT
• Otis Washington, LCSW
• Jessica Paige Watkins, RPT
• John Bennett Weaver II, MD
• Kristopher Ross Weemes, D.O.
• Gary R. Weldon, D.M.D.
• Megan Whatley
• Gregory Shawn Wheeler, N.P.

• Professional Counselor in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.