Provider Demographics
NPI:1275775918
Name:WEINGARD, MARILYN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:
Last Name:WEINGARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4772
Mailing Address - Country:US
Mailing Address - Phone:516-546-2824
Mailing Address - Fax:516-546-2824
Practice Address - Street 1:2727 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4772
Practice Address - Country:US
Practice Address - Phone:516-546-2824
Practice Address - Fax:516-546-2824
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037508-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health