Provider Demographics
NPI:1033215041
Name:WEINSTEIN, MARK A (LMHC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 HARMON ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2713
Mailing Address - Country:US
Mailing Address - Phone:516-889-0613
Mailing Address - Fax:
Practice Address - Street 1:53 HARMON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2713
Practice Address - Country:US
Practice Address - Phone:516-889-0613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2991101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health