Provider Demographics
NPI:1508964339
Name:WELLS, JEFFREY SCOTT (LMFT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:SCOTT
Last Name:WELLS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2132
Mailing Address - Country:US
Mailing Address - Phone:641-236-4680
Mailing Address - Fax:641-236-8818
Practice Address - Street 1:827 HIGH ST
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2132
Practice Address - Country:US
Practice Address - Phone:641-236-4680
Practice Address - Fax:641-236-8818
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38234106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist