James Weaver Psychological Services PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

014825 Issued in NY

Legal business name

JAMES WEAVER PSYCHOLOGICAL SERVICES PC

Practice address

1994 E Main St
Mohegan Lake, NY 10547-1231

Phone

(646) 239-9357

NPI assigned

Mar 19, 2013

Organization subpart

No

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

Authorized official

Name

Dr. James WeaverNPI 1790813426

Title

President/Owner

Phone

(646) 239-9357

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Clair Weaver, PH.D.

  • Clinical Psychologist
  • Bronx, NY
  • NPI 1790813426
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1720320690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 ENLOE ST",
            "city": "LAKE PEEKSKILL",
            "state": "NY",
            "postal_code": "105371201",
            "telephone_number": "646-239-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1994 E MAIN ST",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471231",
            "telephone_number": "646-239-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES WEAVER PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "646-239-9357",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "014825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02696308",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia M Greco, M.A., CCC-SLP
• Danielle Guilderson
• Taylor Nicole Heitmann, OTR/L
• Ingrid N. Hiller, LPN
• Jennifer Jamal, RDN, CDN
• Deborah C. Jarry, CDN
• Farrah Jean-Baptiste, OD
• Betty Joffee
• Megan Johnson
• Josmi Medical Solutions PC

• Psychologist in Mohegan Lake, NY
• Providers in Mohegan Lake, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.