Healthcare Provider Details

I. General information

NPI: 1821916099
Provider Name (Legal Business Name): WEISS PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W 96TH ST APT 2B
NEW YORK NY
10025-6412
US

IV. Provider business mailing address

110 W 96TH ST APT 2B
NEW YORK NY
10025-6412
US

V. Phone/Fax

Practice location:
  • Phone: 347-504-1067
  • Fax:
Mailing address:
  • Phone: 347-504-1067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN WEISS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 347-504-1067