Provider Demographics
NPI:1205104064
Name:WEINSTOCK, ALEX J (MSW)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:J
Last Name:WEINSTOCK
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 STEARNS HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-3344
Mailing Address - Country:US
Mailing Address - Phone:203-313-2278
Mailing Address - Fax:
Practice Address - Street 1:1115 WEST CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:NY
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-588-5751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health