Provider Demographics
NPI:1942459185
Name:WEINBERG, LISA NANCY (LMSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:NANCY
Last Name:WEINBERG
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 1:21 HEATHCOTE DR
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-2224
Mailing Address - Country:US
Mailing Address - Phone:516-445-8241
Mailing Address - Fax:
Practice Address - Street 1:21 HEATHCOTE DR
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-2224
Practice Address - Country:US
Practice Address - Phone:516-445-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028515-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker