Debra a Weaver PHD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY4836 Issued in FL

Legal business name

DEBRA A WEAVER PHD LLC

Practice address

2880 Capital Medical Blvd
Suite 2
Tallahassee, FL 32308-4671

Phone

(850) 942-5585

Fax

(850) 222-1194

NPI assigned

Mar 30, 2011

Last updated

Mar 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Debra A Weaver, PHDNPI 1285658047

Title

President

Phone

(850) 942-5585

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Debra Ann Weaver, PH.D.

  • Clinical Psychologist
  • Tallahassee, FL
  • NPI 1285658047
  Medicare reassignment NPD Authorized official
• C. Vincent Dix, PH.D.

  • Counseling Psychologist
  • Tallahassee, FL
  • NPI 1134108194
  NPD (past)
• Linda Enfinger, RN, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
  • NPI 1528032372
  NPD (past)
• Alan R Kagan, M.D.

  • Psychiatry Physician
  • Tallahassee, FL
  • NPI 1205813508
  NPD (past)

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1184913105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 CAPITAL MEDICAL BLVD",
            "address_2": "SUITE 2",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084671",
            "telephone_number": "850-942-5585",
            "fax_number": "850-222-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 CAPITAL MEDICAL BLVD",
            "address_2": "SUITE 2",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084671",
            "telephone_number": "850-942-5585",
            "fax_number": "850-222-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA A WEAVER PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-942-5585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF FLORIDA",
            "identifier": "59382",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter C. Debelius-Enemark, M.D.
• Deborah J Ebener PHD
• Deborah Senesac, LCSW Inc.
• Deborah Zurschmiede PHD PA
• Anthony Debose
• Debra Vangaasbeek Arnp, MSN, Inc
• Tailyn Mae Debruyne
• Elijah Decamillo, LCSW
• Kathryn Anne Decarlo
• Allyson Nicole Decastro, LCSW

• Clinical Psychologist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.