Provider Demographics
NPI:1629101480
Name:WEINSTEIN, JIM (MBA, MFT)
Entity Type:Individual
Prefix:MR
First Name:JIM
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MBA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 Q ST NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6351
Mailing Address - Country:US
Mailing Address - Phone:202-667-0665
Mailing Address - Fax:202-667-0665
Practice Address - Street 1:1633 Q ST NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6351
Practice Address - Country:US
Practice Address - Phone:202-667-0665
Practice Address - Fax:202-667-0665
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMFT000009101YM0800X
CAMFC34922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health