Provider Demographics
NPI:1518857390
Name:WEISS, SAMUEL (MSW)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PRAGUE PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6113
Mailing Address - Country:US
Mailing Address - Phone:347-263-0681
Mailing Address - Fax:
Practice Address - Street 1:9 PRAGUE PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-6113
Practice Address - Country:US
Practice Address - Phone:347-263-0681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker