Andrew Charles Weis, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4736 Issued in MN

Practice address

158 Water St N Ste 1
Northfield, MN 55057-2125

Phone

(507) 649-1286

NPI assigned

Sep 25, 2020

Last updated

Sep 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Drew Weis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1386251148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 AMES ST",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572806",
            "telephone_number": "507-581-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 WATER ST N STE 1",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572125",
            "telephone_number": "507-649-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIS",
        "first_name": "ANDREW",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DREW",
            "last_name": "WEIS",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jon E Walser-Kuntz, LP
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• Ella Reese Whitten

• Clinical Psychologist in Northfield, MN
• Providers in Northfield, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.