MEDICARE: AMANDA REY WEISSMAN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0701014332	VA

General Provider Information

NPI Number	:	1699462911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA REY WEISSMAN LPC

Provider Business Mailing Address
First Line	:	5802 JANE WAY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-1202
Country	:	US
Telephone Number	:	203-767-5170
Fax Number	:

Provider Business Practice Location Address
First Line	:	5802 JANE WAY
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-1202
Country	:	US
Telephone Number	:	203-767-5170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	10/02/2025

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Directions to “ AMANDA REY WEISSMAN LPC” Practice Location

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