=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689294738
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHILD & FAMILY COGNITIVE BEHAVIORAL PSYCHOLOGY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2020
-----------------------------------------------------
Last Update Date | 04/19/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 HARWOOD CT STE 512514
-----------------------------------------------------
City | SCARSDALE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10583-4121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-361-5283
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 121 NEPERAN RD
-----------------------------------------------------
City | TARRYTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10591-3415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER, DIRECTOR, AND CEO
-----------------------------------------------------
Name | DR. ADAM SCOTT WEISSMAN
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 914-439-5759
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TB0200X
-----------------------------------------------------
Taxonomy Name | Cognitive & Behavioral Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------