Provider Demographics
NPI:1215195821
Name:WEEKS, JENNIFER W (PHD, LPC, CACD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:W
Last Name:WEEKS
Suffix:
Gender:F
Credentials:PHD, LPC, CACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BARR HARBOR DR
Mailing Address - Street 2:FOUR TOWER BRIDGE SUITE 400
Mailing Address - City:WEST CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2977
Mailing Address - Country:US
Mailing Address - Phone:908-892-5877
Mailing Address - Fax:
Practice Address - Street 1:200 BARR HARBOR DR
Practice Address - Street 2:FOUR TOWER BRIDGE SUITE 400
Practice Address - City:WEST CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2977
Practice Address - Country:US
Practice Address - Phone:908-892-5877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6854101YA0400X
PAPC005131101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)