Provider Demographics
NPI:1114258969
Name:WEINBERG, WENDY G (LICSW)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:G
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:769 PLAIN ST
Mailing Address - Street 2:UNIT I
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2118
Mailing Address - Country:US
Mailing Address - Phone:617-847-1950
Mailing Address - Fax:671-847-1950
Practice Address - Street 1:769 PLAIN ST
Practice Address - Street 2:UNIT I
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2118
Practice Address - Country:US
Practice Address - Phone:617-847-1950
Practice Address - Fax:671-847-1950
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10310211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical