MEDICARE: JOHN RAYMOND WEISS

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1316440910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN RAYMOND WEISS

Provider Business Mailing Address
First Line	:	928 LEXINGTON WAY
Second Line	:
City	:	WAUNAKEE
State	:	WI
Zip	:	53597-2104
Country	:	US
Telephone Number	:	608-712-9362
Fax Number	:

Provider Business Practice Location Address
First Line	:	928 LEXINGTON WAY
Second Line	:
City	:	WAUNAKEE
State	:	WI
Zip	:	53597-2104
Country	:	US
Telephone Number	:	608-712-9362
Fax Number	:

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

Provider Enumeration Date	:	03/10/2018
Last Update Date	:	02/04/2026

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