Provider Demographics
NPI:1730490855
Name:WEIDENMUELLER, KARIN E (LMHC)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:E
Last Name:WEIDENMUELLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 DORCHESTER RD APT 2A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5721
Mailing Address - Country:US
Mailing Address - Phone:917-903-4789
Mailing Address - Fax:
Practice Address - Street 1:403 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3921
Practice Address - Country:US
Practice Address - Phone:917-903-4789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004331101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health