Provider Demographics
NPI:1346206711
Name:WEISS, CHRISTINE LINNEA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LINNEA
Last Name:WEISS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:LINNEA
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1045 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7828
Mailing Address - Country:US
Mailing Address - Phone:516-489-4465
Mailing Address - Fax:
Practice Address - Street 1:100 N VILLAGE AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3767
Practice Address - Country:US
Practice Address - Phone:516-505-9742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR036824-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical