Provider Demographics
NPI:1457125734
Name:WEINBERG, KAITLIN THOMAS (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:THOMAS
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CANTERBURY CT
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2802
Mailing Address - Country:US
Mailing Address - Phone:160-957-6438
Mailing Address - Fax:
Practice Address - Street 1:227 LAUREL RD STE 200
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-8303
Practice Address - Country:US
Practice Address - Phone:856-452-1322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05900000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker