Active NPI
Dennis Weise
- Clinical Psychologist
- West Palm Beach, FL
National Provider Identifier
1497972855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY3680
- Practice address
- 224 Datura St Ste 414
West Palm Beach, FL 33401-5632 - Phone
- (561) 707-6311
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PY 3680 | FL | |
| Developmental Therapist | 222Q00000X | PY3680 | FL | |
| Clinical Psychologist | 103TC0700X | PY3680 | FL | Primary |
Addresses
Primary practice location
224 Datura St Ste 414
West Palm Beach, FL 33401-5632
Mailing address
224 Datura St Ste 414
West Palm Beach, FL 33401-5632
Phone (561) 707-6311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810932000 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY3680 | FL | MD | Clinical Psychologist |
| PY 3680 | FL | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557187200000",
"number": "1497972855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 DATURA ST STE 414",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334015632",
"telephone_number": "561-707-6311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 DATURA ST STE 414",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334015632",
"telephone_number": "561-707-6311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISE",
"first_name": "DENNIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2019-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "FL",
"license": "PY 3680",
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": "PY3680",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY3680",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "810932000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.