Provider Demographics
NPI:1437326840
Name:WEEKS, WESLEY (LPC)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:
Last Name:WEEKS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 WEST SEED FARM ROAD
Mailing Address - Street 2:GILA RIVER HEALTH CARE CORPORATION
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85247
Mailing Address - Country:US
Mailing Address - Phone:520-562-3321
Mailing Address - Fax:602-528-1374
Practice Address - Street 1:483 WEST SEED FARM ROAD
Practice Address - Street 2:GILA RIVER HEALTH CARE CORPORATION
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85247-0038
Practice Address - Country:US
Practice Address - Phone:520-562-3321
Practice Address - Fax:602-528-1374
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 11994101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ346214Medicaid