Provider Demographics
NPI:1700090313
Name:WEINSTEIN, PETER (LCSW)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:WEINSTEIN
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 1:1825 MADISON AVE
Mailing Address - Street 2:APT 5J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035
Mailing Address - Country:US
Mailing Address - Phone:212-410-4030
Mailing Address - Fax:
Practice Address - Street 1:19 WEST 34TH STREET
Practice Address - Street 2:PENTHOUSE SUITE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:646-220-0688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0510391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical