Provider Demographics
NPI:1588191035
Name:WEINER, RICHARD (M ED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:WEINER
Suffix:
Gender:M
Credentials:M ED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5636
Mailing Address - Country:US
Mailing Address - Phone:862-823-3404
Mailing Address - Fax:
Practice Address - Street 1:189 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5636
Practice Address - Country:US
Practice Address - Phone:862-823-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor