Provider Demographics
NPI:1255199386
Name:WESTON, TESHAUNDRIA (LMHC, CRC, NCC)
Entity type:Individual
Prefix:
First Name:TESHAUNDRIA
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:LMHC, CRC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9541 103RD ST APT 1221
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-0338
Mailing Address - Country:US
Mailing Address - Phone:850-264-3053
Mailing Address - Fax:
Practice Address - Street 1:9541 103RD ST APT 1221
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-0338
Practice Address - Country:US
Practice Address - Phone:850-264-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL410084225C00000X
390200000X
FLMH24529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program