Provider Demographics
NPI:1154141786
Name:WEINSTEIN, JOSHUA M (PSYS)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:M
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-2004
Mailing Address - Country:US
Mailing Address - Phone:317-550-4800
Mailing Address - Fax:317-644-1841
Practice Address - Street 1:1200 E 42ND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2004
Practice Address - Country:US
Practice Address - Phone:317-550-4800
Practice Address - Fax:317-644-1841
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN14781506103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool