Nancy C Weisman, PH.D.
Individual provider Active NPI Clinical Psychologist · Sanoy Springs, GA
NPI 1861479925 · NPPES record last updated Apr 20, 2023
Key facts
- NPI
- 1861479925
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY001914 (GA)
- Practice address
- 820 Edgewater TR
Sanoy Springs, GA 30328-2825 - Phone
- (404) 324-1223
- Fax
- (404) 256-9062
- NPI assigned
- Dec 29, 2005
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
820 Edgewater Trail
Sandy Springs, GA 30328-2825
820 Edgewater Trial
Sandy Springs, GA 30328-2825
Phone (404) 324-1223
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141030000086 | GA | Practitioner - Clinical Psychologist | 0345461695 | Practice locations: Sandy Springs, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY001914 | GA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY001914 | GA | Yes |
Addresses
Primary practice location
820 Edgewater TR
Sanoy Springs, GA 30328-2825
Mailing address
820 Edgewater TR
Sanoy Springs, GA 30328-2825
Phone (404) 324-1223
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00662769A | Medicaid | GA |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.