Provider Demographics
NPI:1649222696
Name:WEINBERG SMITH, CAROL (MSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:WEINBERG SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37042 KIRKSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1836
Mailing Address - Country:US
Mailing Address - Phone:248-760-9060
Mailing Address - Fax:248-254-3780
Practice Address - Street 1:37042 KIRKSHIRE CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1836
Practice Address - Country:US
Practice Address - Phone:248-760-9060
Practice Address - Fax:248-254-3780
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010191441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N66110Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER