Provider Demographics
NPI:1558804963
Name:WEE, JIA YIN (MED, LCPC)
Entity Type:Individual
Prefix:
First Name:JIA YIN
Middle Name:
Last Name:WEE
Suffix:
Gender:F
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:WEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:218 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2204
Mailing Address - Country:US
Mailing Address - Phone:312-285-2287
Mailing Address - Fax:312-225-8798
Practice Address - Street 1:218 W 26TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2204
Practice Address - Country:US
Practice Address - Phone:312-285-2287
Practice Address - Fax:312-225-8798
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012127101YM0800X
IL180.013024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health