MEDICARE: DR. JESSICA WEATHERFORD PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY10000662	MA

General Provider Information

NPI Number	:	1174305338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA WEATHERFORD PSYD

Provider Business Mailing Address
First Line	:	14 COLONY RD
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-2004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 COLONY RD
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-2004
Country	:	US
Telephone Number	:	925-408-9875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	01/30/2026

Similar Medicare Providers

1346188794 — PAVLINA NICHOLAS ANTIMISIARIS
Practice Location Address:

1376 HARTLAND WOODS WAY
LEXINGTON, KY
40515-2004

Practice Phone: 859-693-7619
Practice Fax:

1629302039 — THOMAS SCOTT APPLEGATE OTR/L
Practice Location Address:

220 LARCH LN
LEXINGTON, KY
40511-2004

Practice Phone: 859-948-0434
Practice Fax:

1548801087 — WILLIAM OFFUTT PETTIT
Practice Location Address:

2004 BLAIRMORE RD
LEXINGTON, KY
40502-2435

Practice Phone: 859-230-9578
Practice Fax:

1811837891 — IRYNA TYLYHUZ
Practice Location Address:

26 PEARL ST
LEXINGTON, MA
02420-2627

Practice Phone: 774-256-1358
Practice Fax:

1508706300 — MENDED MINDS MENTAL HEALTH LLC
Practice Location Address:

57 BEDFORD ST STE 230
LEXINGTON, MA
02420-4502

Practice Phone: 617-213-0435
Practice Fax:

1366399297 — HANNAH PELL
Practice Location Address:

450 BEDFORD ST STE 2400
LEXINGTON, MA
02420-1544

Practice Phone: 703-307-4584
Practice Fax:

Directions to “ DR. JESSICA WEATHERFORD PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.