Weiss, Kenneth I

Weiss, Kenneth I is an sole proprietor health care provider with primary practice located at 115 Main St Suite 2D, North Easton MA 02356-1468. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Ambulatory Health Care Facilities / VA, Behavioral Health & Social Service Providers / Family. Ambulatory Health Care Facilities / VA is his primary health care specialty. Weiss, Kenneth I can be contacted via phone (508) 238-7766.

Contact Information

Primary practice address
115 Main St Suite 2D North Easton MA 02356-1468
Fax: (508) 230-5089
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3881 Massachusetts
Ambulatory Health Care Facilities / VA 261QV0200X 3881 Massachusetts
Behavioral Health & Social Service Providers / Family 103TF0000X 3881 Massachusetts

Profile Details

NPI number 1265469282
LBN Legal business name Weiss, Kenneth I
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2006
Last updated Apr 19th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265469282 NPPES
Massachusetts Other 773102 TUFTS HEALTH PLAN
Massachusetts MEDICAID 1899031 TUFTS HEALTH PLAN
Massachusetts Other WO3901 TUFTS HEALTH PLAN

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