Provider Demographics
NPI:1619232444
Name:WEINBERG, LAUREN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:BRONSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25 LLANFAIR CIRCLE
Mailing Address - Street 2:SENIOR BEHAVIORAL HEALTHCARE GROUP INC
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-3342
Mailing Address - Country:US
Mailing Address - Phone:610-674-9676
Mailing Address - Fax:610-649-4190
Practice Address - Street 1:25 LLANFAIR CIRCLE
Practice Address - Street 2:SENIOR BEHAVIORAL HEALTHCARE GROUP INC.
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-3342
Practice Address - Country:US
Practice Address - Phone:610-674-9676
Practice Address - Fax:610-649-4190
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0173011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical