Glenna Marie Weis, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2002030467 Issued in MO

Practice address

205 West Walnut Street
Springfield, MO 65806-2096

Phone

(417) 425-9100

Fax

(417) 719-9002

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Child and Teen Therapy Solutions LLC

  • Clinical Psychologist
  • Springfield, MO
  • NPI 1255807293
  NPD (past) Authorized official
• New Beginnings Behavioral Health

  • Clinical Psychologist
  • Nixa, MO
  • NPI 1285810432
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1528085172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WEST WALNUT STREET",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658062096",
            "telephone_number": "417-425-9100",
            "fax_number": "417-719-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WEST WALNUT STREET",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658062096",
            "telephone_number": "417-425-9100",
            "fax_number": "417-719-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIS",
        "first_name": "GLENNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2002030467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler James Wegrzyn
• Taylor Ray Wehmeyer, DO
• Jennifer A Weiberg, M ED, LPC
• McKayla Weimer
• Rebecca Allison Weimer, L.P.C.
• Matthew A Weis, M.D.
• Olivia Huff Weis
• Patrick Jerome Weis, PSY.D., LPC, NCC
• Virginia D. Weis, M.A., CCC-SLP
• Lynda D Weiser, MS, NCC, LPC

• Clinical Psychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.