Provider Demographics
NPI:1649757576
Name:BROWNSTEIN, MOSHE (LCSW)
Entity type:Individual
Prefix:
First Name:MOSHE
Middle Name:
Last Name:BROWNSTEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 MONTAGUE CITY RD APT 1F
Mailing Address - Street 2:
Mailing Address - City:TURNERS FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01376-1823
Mailing Address - Country:US
Mailing Address - Phone:773-331-7607
Mailing Address - Fax:
Practice Address - Street 1:164 MONTAGUE CITY RD APT 1F
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1823
Practice Address - Country:US
Practice Address - Phone:773-331-7607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.102194104100000X
MA11211311041C0700X
IL149.0210011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker