Provider Demographics
NPI:1942346382
Name:WEINSTEIN, STEVEN (LMHC,LMFT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:LMHC,LMFT
Other - Prefix:MR
Other - First Name:STEVEN
Other - Middle Name:
Other - Last Name:WEINSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:86 BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3522
Mailing Address - Country:US
Mailing Address - Phone:781-488-3613
Mailing Address - Fax:781-483-2221
Practice Address - Street 1:86 BOSTON AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3522
Practice Address - Country:US
Practice Address - Phone:781-488-3613
Practice Address - Fax:781-483-2221
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA#694OtherL.M.H.C.