Healthcare Provider Details

I. General information

NPI: 1235043704
Provider Name (Legal Business Name): TETON PSYCHOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N HIGHWAY 33 STE 103
DRIGGS ID
83422-5313
US

IV. Provider business mailing address

1420 N HIGHWAY 33 STE 103
DRIGGS ID
83422-5313
US

V. Phone/Fax

Practice location:
  • Phone: 208-497-2260
  • Fax: 208-281-4134
Mailing address:
  • Phone: 208-497-2260
  • Fax: 208-281-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JESSICA WEIS
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 650-380-6265