Provider Demographics
NPI:1083761357
Name:WEIR, JEFFREY (LCMHC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:WEIR
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3837
Mailing Address - Country:US
Mailing Address - Phone:603-224-2841
Mailing Address - Fax:603-228-6018
Practice Address - Street 1:85 WARREN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3837
Practice Address - Country:US
Practice Address - Phone:603-224-2841
Practice Address - Fax:603-228-6018
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH231101YM0800X
MA4452101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30420152Medicaid