Provider Demographics
NPI:1841216173
Name:WEINER, RONNIE JOAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:RONNIE
Middle Name:JOAN
Last Name:WEINER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:RONNIE
Other - Middle Name:JOAN
Other - Last Name:FISHBEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1451 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2860
Mailing Address - Country:US
Mailing Address - Phone:908-322-2871
Mailing Address - Fax:908-322-2863
Practice Address - Street 1:1451 COOPER RD
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-2860
Practice Address - Country:US
Practice Address - Phone:908-322-2871
Practice Address - Fax:908-322-2863
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000799001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ151075OtherMHN BEHAVIORIAL HEALTH
NJ44SC00079900OtherSTATE CLINICAL LICENSE
NJ151075OtherMHN BEHAVIORIAL HEALTH