Healthcare Provider Details

I. General information

NPI: 1972722627
Provider Name (Legal Business Name): JEFFREY ADAM WEISSLITZ PSYD, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 JERSEY AVE REAR
SPRING LAKE NJ
07762-1483
US

IV. Provider business mailing address

217 JERSEY AVE REAR
SPRING LAKE NJ
07762-1483
US

V. Phone/Fax

Practice location:
  • Phone: 908-675-2095
  • Fax:
Mailing address:
  • Phone: 908-675-2095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00302600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11486
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: