# LIFESPAN PSYCHOLOGY, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003205741
- **Authorized official:** DR. KEVIN JAMES WEIS PSY.D. (CHAIRMAN)
- **Authorized official phone:** (954) 260-0361

## Contact information

- **Practice address:** 98 VOORHEES RD E, HAMILTON, GA 31811-5671
- **Practice address phone:** (954) 260-0361
- **Mailing address:** 98 VOORHEES RD E, HAMILTON, GA 31811-5671
- **Mailing address phone:** (706) 582-3647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | PSY003141 | GA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PSY003142 | GA | Yes |

## Other

- **Enumeration date:** 01/19/2015
- **Last updated:** 01/22/2015