NPIMap

Organization Active NPI

Nicola Weiss, PH.D., LLC

  • Clinical Psychologist
  • Englewood, NJ
National Provider Identifier
1487716916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3844 Issued in NJ
Legal business name
NICOLA WEISS, PH.D., LLC
Practice address
416 Gloucester St
Englewood, NJ 07631-4706
Phone
(201) 320-7174
Fax
(800) 724-7270
NPI assigned
Dec 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nicola Weiss, PH.D.NPI 1265594436
Title
Owner
Phone
(201) 320-7174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3844 NJ Primary

Addresses

Primary practice location

416 Gloucester St
Englewood, NJ 07631-4706

Mailing address

416 Gloucester St
Englewood, NJ 07631-4706
Phone (201) 320-7174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050114000072 NJ Part B Supplier - Clinic/Group Practice 0547219735 Receives reassigned benefits from 4 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

163 Engle St
Englewood, NJ 07631
Phone (201) 569-3313

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487716916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 GLOUCESTER ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314706",
            "telephone_number": "201-320-7174",
            "fax_number": "800-724-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 GLOUCESTER ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314706",
            "telephone_number": "201-320-7174",
            "fax_number": "800-724-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLA WEISS, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-320-7174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "3844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.