Organization Active NPI

Marie C. Weil, PSYD, LLC

  • Clinical Psychologist
  • Silver City, NM
National Provider Identifier
1861054298
Registry record updated Mar 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MARIE C. WEIL, PSYD, LLC
Practice address
206 E 11TH St
Silver City, NM 88061-5503
Phone
(575) 342-1236
NPI assigned
Jul 6, 2019
Last updated
Mar 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2023

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

Authorized official

Name
Marie C Weil, PSYDNPI 1083893424
Title
Member
Phone
(575) 342-1236

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X Primary
Health PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TH0004X

Addresses

Primary practice location

206 E 11TH St
Silver City, NM 88061-5503

Mailing address

PO Box 922
Silver City, NM 88062-0922
Phone (575) 342-1236

Other identifiers 1

IdentifierTypeStateIssuer
79050093MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190817000074 NM Part B Supplier - Clinic/Group Practice 3971831785 Receives reassigned benefits from 1 practitioner
Practice locations: Silver City, NM

National Provider Directory

National Provider Directory

Locations

206 E 11th St
Silver City, NM 88061
Phone (575) 202-2713

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1562371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679702400000",
    "number": "1861054298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 922",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880620922",
            "telephone_number": "575-342-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E 11TH ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880615503",
            "telephone_number": "575-342-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIE C. WEIL, PSYD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-06",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-25",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "575-342-1236",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79050093",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2023; 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.