Theodore J Weber M Div PSYD PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY6429 Issued in FL

Legal business name

THEODORE J WEBER M DIV PSYD PA

Practice address

348 Chelsea Place Ave
Ormond Beach, FL 32174-0683

Phone

(478) 475-1299

NPI assigned

Feb 23, 2009

Last updated

Feb 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Theodore WeberNPI 1316975691

Title

PSYD

Phone

(478) 475-1299

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Theodore Joseph Weber, M.DIV., PSY.D.

  • Psychologist
  • Ormond Beach, FL
  • NPI 1316975691
  Authorized official Same address or phone

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1790925386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28410",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312218410",
            "telephone_number": "478-475-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 CHELSEA PLACE AVE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321740683",
            "telephone_number": "478-475-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE J WEBER M DIV PSYD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "PSYD",
        "authorized_official_telephone_number": "478-475-1299"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.