Jessica Lynn Weeden, LCSW

Individual provider Active NPI Clinical Social Worker · Sidney, NY

NPI 1194441014 · NPPES record last updated Oct 12, 2022

Key facts

NPI
1194441014
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
093514-01 (NY)
Practice address
45 Willow St
Sidney, NY 13838-1219
Phone
(607) 435-6073
NPI assigned
Oct 12, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
093514-01NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093514-01 NY Yes

Addresses

Primary practice location

45 Willow St
Sidney, NY 13838-1219

Mailing address

45 Willow St
Sidney, NY 13838-1219
Phone (607) 435-6073

Other providers in Sidney, NY

All providers in Sidney, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.