Provider Demographics
NPI:1528289097
Name:MAYS, JEREMIAH (LMFT)
Entity type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:MAYS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:JEREMY
Other - Middle Name:
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 W ALDER ST STE 236
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2863
Mailing Address - Country:US
Mailing Address - Phone:206-707-9115
Mailing Address - Fax:
Practice Address - Street 1:5 W ALDER ST STE 236
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2863
Practice Address - Country:US
Practice Address - Phone:206-707-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 60396336106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist