Provider Demographics
NPI:1851643803
Name:WEINSTOCK, BARBARA R (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:R
Last Name:WEINSTOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 SOUTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3042
Mailing Address - Country:US
Mailing Address - Phone:804-378-8254
Mailing Address - Fax:804-378-3264
Practice Address - Street 1:545 SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3042
Practice Address - Country:US
Practice Address - Phone:804-378-8254
Practice Address - Fax:804-378-3264
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040015051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical