Provider Demographics
NPI:1891348876
Name:WEISS, HEIDI (LMSW)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PUTNAM GRN APT C
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6040
Mailing Address - Country:US
Mailing Address - Phone:914-645-8378
Mailing Address - Fax:
Practice Address - Street 1:17 PUTNAM GRN APT C
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6040
Practice Address - Country:US
Practice Address - Phone:914-645-8378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070853104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker