Healthcare Provider Details

I. General information

NPI: 1538291554
Provider Name (Legal Business Name): WEEKS AND VIETRI COUNSELING & COMMUNITY SERVICES. PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 S WASHINGTON ST
MOSCOW ID
83843-3049
US

IV. Provider business mailing address

818 S WASHINGTON ST
MOSCOW ID
83843-3049
US

V. Phone/Fax

Practice location:
  • Phone: 208-882-8514
  • Fax: 208-882-2784
Mailing address:
  • Phone: 208-882-8514
  • Fax: 208-882-2784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number202119
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number217
License Number StateID

VIII. Authorized Official

Name: DR. CATHERINE JEAN WEEKS
Title or Position: OWNER
Credential: PH.D.
Phone: 208-882-8514