Provider Demographics
NPI:1083948608
Name:WEED, JESSICA BETH (LMHCA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BETH
Last Name:WEED
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S JEFFERSON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3143
Mailing Address - Country:US
Mailing Address - Phone:509-768-6852
Mailing Address - Fax:509-232-5552
Practice Address - Street 1:400 S JEFFERSON ST STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3143
Practice Address - Country:US
Practice Address - Phone:509-768-6852
Practice Address - Fax:509-232-5552
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61380825101YM0800X
NM176B00000X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM88956750Medicaid