Provider Demographics
NPI:1144194705
Name:WEAVER, JOHN (MS, LPC-A)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:WEAVER
Suffix:
Gender:X
Credentials:MS, LPC-A
Other - Prefix:
Other - First Name:GENESIUS
Other - Middle Name:FAEROSE
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3841 HABERSHAM
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7300 BLANCO RD STE 502
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4936
Practice Address - Country:US
Practice Address - Phone:210-816-1261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health