Provider Demographics
NPI:1184908782
Name:WEINTHALER, JUDITH ANNE (LICSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANNE
Last Name:WEINTHALER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3243
Mailing Address - Country:US
Mailing Address - Phone:413-774-6252
Mailing Address - Fax:413-773-0477
Practice Address - Street 1:238 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3243
Practice Address - Country:US
Practice Address - Phone:413-774-6252
Practice Address - Fax:413-773-0477
Is Sole Proprietor?:No
Enumeration Date:2011-10-01
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical