| James Weaver Psychological Services Pc | |
|
1994 E Main St Mohegan Lake NY 10547-1231 | |
| (646) 239-9357 | |
| Not Available |
| Full Name | James Weaver Psychological Services Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1994 E Main St, Mohegan Lake, New York |
| Authorized Official Name and Position | James Weaver (PRESIDENT/OWNER) |
| Authorized Official Contact | 6462399357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James Weaver Psychological Services Pc 38 Enloe St Lake Peekskill NY 10537-1201 Ph: (646) 239-9357 | James Weaver Psychological Services Pc 1994 E Main St Mohegan Lake NY 10547-1231 Ph: (646) 239-9357 |
| NPI Number | 1720320690 |
|---|---|
| Provider Enumeration Date | 03/19/2013 |
| Last Update Date | 03/19/2013 |
| Medicare PECOS PAC ID | 8628217593 |
|---|---|
| Medicare Enrollment ID | O20130626000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720320690 | NPI | - | NPPES |
| 02696308 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 014825 (New York) | Primary |
| Provider Name | James Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790813426 PECOS PAC ID: 3375641194 Enrollment ID: I20070601000329 |
Aurora Wellness Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1713 Lawrence Rd, Mohegan Lake, NY 10547 Phone: 914-438-5121 |