Provider Demographics
NPI:1104940097
Name:WEINER, SEALANI BRANSON (MSW, MS C ED)
Entity type:Individual
Prefix:MS
First Name:SEALANI
Middle Name:BRANSON
Last Name:WEINER
Suffix:
Gender:F
Credentials:MSW, MS C ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 VILLANOVA RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2634
Mailing Address - Country:US
Mailing Address - Phone:240-353-2352
Mailing Address - Fax:
Practice Address - Street 1:7601 VILLANOVA RD
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2634
Practice Address - Country:US
Practice Address - Phone:240-353-2352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12698101Y00000X, 104100000X, 1041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator