Provider Demographics
NPI:1134514193
Name:THERESA (TRACY) M. WEEKS, PSY.D, LLC
Entity Type:Organization
Organization Name:THERESA (TRACY) M. WEEKS, PSY.D, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:513-257-5873
Mailing Address - Street 1:7681 TYLERS PLACE BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6392
Mailing Address - Country:US
Mailing Address - Phone:513-508-2628
Mailing Address - Fax:513-779-9209
Practice Address - Street 1:7681 TYLERS PLACE BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6392
Practice Address - Country:US
Practice Address - Phone:513-508-2628
Practice Address - Fax:513-779-9209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6838103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty