Provider Demographics
NPI:1740444306
Name:CUSHNER WEINSTEIN, SANDRA M (PT, LCSW-C)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:CUSHNER WEINSTEIN
Suffix:
Gender:F
Credentials:PT, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9850 KEY WEST ROCKVILLE
Mailing Address - Street 2:MD 20850
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:202-476-5142
Mailing Address - Fax:202-476-2676
Practice Address - Street 1:9850 KEY WEST ROCKVILLE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:202-476-5142
Practice Address - Fax:202-476-2676
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD070201041C0700X
DCLC3030581041C0700X
MD14550174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1376748632OtherNPI