Provider Demographics
NPI:1962443754
Name:LONNY C WEISS PSY D PA
Entity Type:Organization
Organization Name:LONNY C WEISS PSY D PA
Other - Org Name:WEISS THERAPY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNY
Authorized Official - Middle Name:CLIFF
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:561-630-0865
Mailing Address - Street 1:4362 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6275
Mailing Address - Country:US
Mailing Address - Phone:561-630-0865
Mailing Address - Fax:561-630-0866
Practice Address - Street 1:4362 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6275
Practice Address - Country:US
Practice Address - Phone:561-630-0865
Practice Address - Fax:561-630-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 6534103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty