MEDICARE: ANNA SYLVIA WEBER PSYD

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	103T00000X	Psychologist	5274-57	WI
2	101YM0800X	Mental Health Counselor
3	103TC0700X	Clinical Psychologist	5274-57	WI

General Provider Information

NPI Number	:	1861161861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA SYLVIA WEBER PSYD

Provider Business Mailing Address
First Line	:	850 ELM GROVE RD STE 17
Second Line	:
City	:	ELM GROVE
State	:	WI
Zip	:	53122-2527
Country	:	US
Telephone Number	:	414-909-0114
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 ELM GROVE RD STE 17
Second Line	:
City	:	ELM GROVE
State	:	WI
Zip	:	53122-2527
Country	:	US
Telephone Number	:	414-909-0114
Fax Number	:

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

Provider Enumeration Date	:	09/13/2021
Last Update Date	:	01/01/2026

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