MEDICARE: MS. MARIE C BEAUREGARD-WEISS LCSW

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	1041C0700X	Clinical Social Worker	050794	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134217508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIE C BEAUREGARD-WEISS LCSW

Provider Business Mailing Address
First Line	:	10501 WOODLAND WATERS BLVD
Second Line	:
City	:	WEEKI WACHEE
State	:	FL
Zip	:	34613-6410
Country	:	US
Telephone Number	:	917-470-0284
Fax Number	:	352-293-3137

Provider Business Practice Location Address
First Line	:	2078 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3916
Country	:	US
Telephone Number	:	917-470-0284
Fax Number	:	352-293-3137

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	12/09/2024

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Directions to “ MS. MARIE C BEAUREGARD-WEISS LCSW” Practice Location

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