Holly Weiss

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00737400 Issued in NJ

Practice address

212 E Madison Ave
Magnolia, NJ 08049-1409

Phone

(856) 602-4834

Fax

(856) 309-9716

NPI assigned

Jun 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Jersey Behavioral Health Resources IncorporatedGroup PAC ID 2264503937, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• South Jersey Behavioral Health Resources Incorporated

  • Community/Behavioral Health Agency
  • Camden, NJ
  • NPI 1255491718
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1982380895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E MADISON AVE",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491409",
            "telephone_number": "856-602-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E MADISON AVE",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491409",
            "telephone_number": "856-602-4834",
            "fax_number": "856-309-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00737400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Jersey Behavioral Health Resources Incorporated
• Olivia Stone
• An Xuan Tran, DMD
• Joanne Bundalian Tran
• Walgreen Co
• Jessica M Wescott, LPN
• Mandy Witt, M.S.
• Latanya Wood El, RN

• Mental Health Counselor in Magnolia, NJ
• Providers in Magnolia, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.