Individual provider Active NPI

Sean Weiss, LCSW, LCADC

  • Clinical Social Worker
  • Marlton, NJ
National Provider Identifier
1932822012
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06120200 Issued in NJ
Practice address
750 Route 73 S Ste 210
Marlton, NJ 08053-4133
Phone
(856) 399-1010
NPI assigned
Sep 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00341900 NJ
Clinical Social Worker 1041C0700X 44SC06120200 NJ Primary

Addresses

Primary practice location

750 Route 73 S Ste 210
Marlton, NJ 08053-4133

Mailing address

65 Morley Blvd
Medford, NJ 08055-9621
Phone (609) 385-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37LC00341900NJMDAddiction (Substance Use Disorder) Counselor
44SC06120200NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Synapse Behavioral Health Inc CurrentSince Sep 25, 2022 Accepting new patients

Locations

750 Route 73 S
Ste 210
Marlton, NJ 08053
Phone (856) 399-1010

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1932822012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MORLEY BLVD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559621",
            "telephone_number": "609-385-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ROUTE 73 S STE 210",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534133",
            "telephone_number": "856-399-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "SEAN",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00341900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06120200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.