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General NPI Number Information
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NPI Number | 1831917947
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Entity Type | Organization
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Legal Business Name | JEAN WEILLE, LCSW PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 119 W 57TH ST STE 1510
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City | NEW YORK
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State | NY
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Zip | 10019-2401
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Country | US
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Telephone | 347-588-3110
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Fax |
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Provider Business Mailing Address
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Address Line | 66 OVERLOOK TER APT 7E
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City | NEW YORK
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State | NY
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Zip | 10040-3829
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Country | US
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Telephone | 347-588-3110
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Fax |
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | MS. JEAN WEILLE
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Credential | LCSW
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Telephone | 237-588-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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