Jill Reid Weadick, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-2986 Issued in ID

Practice address

1075 S Utah Ave Ste 354
Idaho Falls, ID 83402-3320

Phone

(208) 529-5777

Fax

(208) 529-5778

NPI assigned

Feb 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jill Darcy Reid Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1140307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1740255264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6133 S MARBRISA LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834068243",
            "telephone_number": "208-569-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 S UTAH AVE STE 354",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023320",
            "telephone_number": "208-529-5777",
            "fax_number": "208-529-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEADICK",
        "first_name": "JILL",
        "middle_name": "REID",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-19",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-2986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "REID",
            "middle_name": "DARCY",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaylee Waters, PT, DPT
• Bruce James Watkins, M.D.
• Todd Chandler Watson, DDS
• Brandi Lynn Watt, DNP, APRN, NNP-BC
• Raymond Wayne, PTA
• John Weatherly, R.P.T.
• Lonnie Robert Weathermon, PHARMD
• Bracken Webb, DDS
• Chad Robert Webb, D.C.
• Chelsi Ann Webb, LMSW

• Mental Health Counselor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.