Provider Demographics
NPI:1528551470
Name:WEAVER, HARVEY A (QMHS)
Entity type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:A
Last Name:WEAVER
Suffix:
Gender:M
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 DRYDEN RD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439
Mailing Address - Country:US
Mailing Address - Phone:937-461-4300
Mailing Address - Fax:937-461-0443
Practice Address - Street 1:2621 DRYDEN RD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439
Practice Address - Country:US
Practice Address - Phone:973-293-1945
Practice Address - Fax:937-461-0443
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1326012360OtherAGENCY NPI