Provider Demographics
NPI:1083748818
Name:WEINER, RONALD IRA (MSW, PHD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:IRA
Last Name:WEINER
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 K ST NW
Mailing Address - Street 2:SUITE 634
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-1202
Mailing Address - Country:US
Mailing Address - Phone:202-367-0234
Mailing Address - Fax:202-367-0235
Practice Address - Street 1:1522 K ST NW
Practice Address - Street 2:SUITE 634
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-1202
Practice Address - Country:US
Practice Address - Phone:202-367-0234
Practice Address - Fax:202-367-0235
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3005251041C0700X
MD001331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical