Provider Demographics
NPI:1538291554
Name:WEEKS AND VIETRI COUNSELING & COMMUNITY SERVICES. PS
Entity Type:Organization
Organization Name:WEEKS AND VIETRI COUNSELING & COMMUNITY SERVICES. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:208-882-8514
Mailing Address - Street 1:818 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-3049
Mailing Address - Country:US
Mailing Address - Phone:208-882-8514
Mailing Address - Fax:208-882-2784
Practice Address - Street 1:818 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-3049
Practice Address - Country:US
Practice Address - Phone:208-882-8514
Practice Address - Fax:208-882-2784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID217101YP2500X
ID202119103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8053401Medicaid
WA820495613AAOtherUNIFORM INSURANCE
IDN6278OtherBLUE CROSS OF IDAHO
ID8040032Medicaid
ID2V29936OtherBUSINESS PSYCHOLOGY ASSOC
ID8041410Medicaid
ID000010016330OtherREGENCE BLUE SHIELD