Provider Demographics
NPI:1700092541
Name:WIEBE, JAMES N (MS, LMFT-A)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:N
Last Name:WIEBE
Suffix:
Gender:M
Credentials:MS, LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 WESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-8568
Mailing Address - Country:US
Mailing Address - Phone:214-514-6150
Mailing Address - Fax:
Practice Address - Street 1:2400 STATE HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-5103
Practice Address - Country:US
Practice Address - Phone:972-867-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201068106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist