Individual provider Active NPI

Jessica Fern Weller, MFT

  • Marriage & Family Therapist
  • Plainview, NY
National Provider Identifier
1134747660
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
535 S Oyster Bay Rd
Plainview, NY 11803-3310
Phone
(516) 818-8383
NPI assigned
Jul 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

535 S Oyster Bay Rd
Plainview, NY 11803-3310

Mailing address

48 Sullivan Dr
Jericho, NY 11753-1940
Phone (516) 880-4211

Other practice location 1

50 W Hawthorne Ave
Valley Stream, NY 11580-6223
Phone (516) 569-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Assessment and Screening Services PC CurrentSince Oct 30, 2024 Accepting new patients

Locations

535 S Oyster Bay Rd
Plainview, NY 11803
Phone (516) 818-8383

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1134747660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 SULLIVAN DR",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531940",
            "telephone_number": "516-880-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S OYSTER BAY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033310",
            "telephone_number": "516-818-8383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 W Hawthorne Ave",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115806223",
            "country_code": "US",
            "telephone_number": "516-569-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLER",
        "first_name": "JESSICA",
        "middle_name": "FERN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.