Provider Demographics
NPI:1376600254
Name:WEISS, PETER JOSEPH (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:JOSEPH
Last Name:WEISS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HICKS STREET
Mailing Address - Street 2:#21J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1655
Mailing Address - Country:US
Mailing Address - Phone:718-858-0248
Mailing Address - Fax:
Practice Address - Street 1:110 20 71 ROAD
Practice Address - Street 2:ARISTA CENTER FOR PSYCHOTHERAPY
Practice Address - City:FOREST HILLS QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-793-3133
Practice Address - Fax:718-793-2023
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0078531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY41J64RMedicare ID - Type Unspecified
R28080Medicare UPIN