JACQUELINE R WEAVER


Address: 2200 Kernan Dr Ofc 1219, Baltimore, MD 21207-6665
Phone: 4104482500

JACQUELINE R WEAVER (NPI# 1588008510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588008510
Entity Type Individual
Full Name JACQUELINE R WEAVER
Credential PSY.D.
Practice Address 2200 Kernan Dr Ofc 1219
Baltimore
MD 21207-6665
Practice Telephone 4104482500
Practice Fax Number 4104486791
Mailing Telephone 4104482500
Mailing Fax Number 4104486917
Enumeration Date 2013-04-21
Last Update Date 2020-02-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 05792 MD Behavioral Health & Social Service Providers
N 103TC0700X Psychologist
Specialization: Clinical
05792 MD Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MD HOSPITAL 1841337805 01

Other Providers JACQUELINE WEAVER

NPI Name Taxonomy Address Enumeration
1407097702 Jacqueline Christine Weaver Chiropractor 4526 Buffalo Gap Rd, Abilene, TX 79606-2704 2009-03-16
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1336560879 Jacqueline Weaver Nurse Practitioner 555 N Duke St, Lancaster, PA 17602-2250 2013-12-31
1538417167 Jacqueline La Barbera Weaver Registered Nurse 4600 Broadway, Sacramento, CA 95820-1527 2012-08-29
1669720637 Jacqueline Kimbell Weaver Pharmacist 1208 Homer Rd, Minden, LA 71055-3082 2012-08-26
1154510485 Jacqueline Weaver Case Manager/Care Coordinator 210 Manor St, Marion, AR 72364-1936 2007-10-23
1902946890 Jacqueline Weaver Emergency Medicine 2215 Burdett Ave, Troy, NY 12180-2466 2007-02-08

Office Location

Street Address 2200 KERNAN DR OFC 1219
City BALTIMORE
State MD
Zip Code 21207-6665

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1255720439 Dawn James Counselor 6401 Dogwood Road, Suite 201, Gwynn Oak, MD 21207 2015-01-12
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902333107 Keenan Alexander Walker Clinical Neuropsychologist Phipps, Room 446, 600 North Wolfe Street, Baltimore, MD 21287 2017-05-18
1275875221 Matthew Lawrence Cohen Clinical Neuropsychologist Meyer 218 The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287-0005 2013-03-17
1972898062 Joseph Jason Van Steenburgh Clinical Neuropsychologist 1629 Thames St Ste 350, Division of Cognitive Neurology, Baltimore, MD 21231-3440 2011-06-16
1346554011 Lindsey Elizabeth Kirsch-darrow Clinical Neuropsychologist Physical Medicine and Rehab 600 North Wolfe St, Phipps 174, Baltimore, MD 21287-0001 2010-08-04
1366699076 Sally Long Clinical Neuropsychologist 600 N. Wolfe St, Meyer 218, Baltimore, MD 21287-7218 2008-08-25
1326236571 Brenda Hanna-pladdy Clinical Neuropsychologist 110 S Paca Street 3rd Floor, University of Maryland School of Medicine, Baltimore, MD 21201 2007-10-11
1972116200 Kalina Eneva Hurley Clinical Neuropsychologist 1708 W Rogers Ave, Baltimore, MD 21209-4596 2020-08-26
1396356077 Jessica Cinda Dalrymple Clinical Neuropsychologist 10 N Greene St, Baltimore, MD 21201-1524 2020-08-14
1457960650 Marilyn Albert Clinical Neuropsychologist 1620 Mcelderry St, Baltimore, MD 21205-1911 2020-07-24
1861015802 Linda Diana Ruiz Clinical Neuropsychologist 10 N Greene St, Baltimore, MD 21201-1524 2020-05-26
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Competitor

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City BALTIMORE
Zip Code 21207

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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