Provider Demographics
NPI:1992190706
Name:WEISS PSYCHOTHERAPY GROUP
Entity Type:Organization
Organization Name:WEISS PSYCHOTHERAPY GROUP
Other - Org Name:WEISS AND ASSOCIATES IN THERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CST
Authorized Official - Phone:561-756-8908
Mailing Address - Street 1:5290 PARK PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1461
Mailing Address - Country:US
Mailing Address - Phone:561-756-8908
Mailing Address - Fax:
Practice Address - Street 1:5290 PARK PLACE CIR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1461
Practice Address - Country:US
Practice Address - Phone:561-756-8908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2947106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty