Individual provider Active NPI

Marjorie Ellen Weishaar, PH.D.

  • Psychologist
  • Providence, RI
National Provider Identifier
1497878813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS 293 Issued in RI
Practice address
295 Angell St
Providence, RI 02906-2119
Phone
(401) 861-3232
Fax
(401) 861-1180
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS 293 RI Primary

Addresses

Primary practice location

295 Angell St
Providence, RI 02906-2119

Mailing address

121 Emeline St
Providence, RI 02906-4204
Phone (401) 861-1180

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS 293RIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497878813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 EMELINE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064204",
            "telephone_number": "401-861-1180",
            "fax_number": "401-861-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 ANGELL ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062119",
            "telephone_number": "401-861-3232",
            "fax_number": "401-861-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISHAAR",
        "first_name": "MARJORIE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS 293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.