MEDICARE: DR. JAMIE SUE WEISS ,PHD, MA

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	101YM0800X	Mental Health Counselor	MT2947	FL
2	106H00000X	Marriage & Family Therapist		FL

General Provider Information

NPI Number	:	1730581679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE SUE WEISS ,PHD, MA

Provider Business Mailing Address
First Line	:	3275 W HILLSBORO BLVD STE 300
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9474
Country	:	US
Telephone Number	:	615-213-6327
Fax Number	:	561-516-8077

Provider Business Practice Location Address
First Line	:	3275 W HILLSBORO BLVD STE 300
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9474
Country	:	US
Telephone Number	:	615-213-6327
Fax Number	:	561-516-8087

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

Provider Enumeration Date	:	09/23/2014
Last Update Date	:	03/20/2020

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