Provider Demographics
NPI:1124858659
Name:WEAVER, ALISHA CML (LMHCA)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:CML
Last Name:WEAVER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 11TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2555
Mailing Address - Country:US
Mailing Address - Phone:360-414-8600
Mailing Address - Fax:360-636-7372
Practice Address - Street 1:945 11TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2555
Practice Address - Country:US
Practice Address - Phone:360-414-8600
Practice Address - Fax:360-636-7372
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health