Provider Demographics
NPI:1225448459
Name:WEIS, JAYME (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:
Last Name:WEIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 HAROLD AVE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1701
Mailing Address - Country:US
Mailing Address - Phone:845-527-2473
Mailing Address - Fax:
Practice Address - Street 1:141 HAROLD AVE
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1701
Practice Address - Country:US
Practice Address - Phone:845-527-2473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062267104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker