Individual provider Active NPI

Jennifer Weseman, LCPC

  • Mental Health Counselor
  • Garden City, ID
National Provider Identifier
1003425547
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCPC-9127 Issued in ID
Practice address
175 E 50TH St
Garden City, ID 83714-1413
Phone
(208) 917-1863
Fax
(208) 906-0815
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-7700 ID
Mental Health Counselor 101YM0800X LCPC-9127 ID Primary

Addresses

Primary practice location

175 E 50TH St
Garden City, ID 83714-1413

Mailing address

175 E 50TH St
Garden City, ID 83714-1413
Phone (208) 917-1863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-9127IDMDMental Health Counselor
LPC-7700IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hand in Hand LLC PastSince Aug 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1003425547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E 50TH ST",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141413",
            "telephone_number": "208-917-1863",
            "fax_number": "208-906-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E 50TH ST",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141413",
            "telephone_number": "208-917-1863",
            "fax_number": "208-906-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESEMAN",
        "first_name": "JENNIFER",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-7700",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-9127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, ID

Sources for this page

Verify at the official NPI Registry.