JACQUELINE R WEAVER PSY.D. NPI 1588008510

NPI Information

NPI: 1588008510
Provider Name: JACQUELINE R WEAVER, PSY.D.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2200 KERNAN DR OFC 1219
BALTIMORE, MD
ZIP 21207
Phone: (410) 448-2500
Get Directions

Jacqueline R Weaver, PSY.D. is a clinical neuropsychologist in Baltimore, MD. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Jacqueline R Weaver, PSY.D. NPI is 1588008510. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2200 KERNAN DR OFC 1219
BALTIMORE, MD
ZIP 21207-665
Phone: (410) 448-2500
Fax: (410) 448-6791

The NPI 1588008510 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 4/21/2013 and was last updated on 2/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC0700X	Psychologist	Clinical	05792	MARYLAND	No
2	103G00000X	Clinical Neuropsychologist		05792	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1841337805	OTHER	MARYLAND	HOSPITAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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