Provider Demographics
NPI:1790137693
Name:CAROL WEISS
Entity Type:Organization
Organization Name:CAROL WEISS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSY.D.
Authorized Official - Prefix:
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-577-0075
Mailing Address - Street 1:7890 PETERS RD
Mailing Address - Street 2:STE. G-107
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7890 PETERS RD
Practice Address - Street 2:STE. G-107
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4028
Practice Address - Country:US
Practice Address - Phone:954-577-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. HELENE COHEN & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1962622480Medicare UPIN