Provider Demographics
NPI:1194060988
Name:WEINTRAUB, SIMKHA YITZKHAK (LCSW)
Entity type:Individual
Prefix:
First Name:SIMKHA
Middle Name:YITZKHAK
Last Name:WEINTRAUB
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 1:325 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4607
Mailing Address - Country:US
Mailing Address - Phone:646-296-4226
Mailing Address - Fax:
Practice Address - Street 1:325 SMITH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4607
Practice Address - Country:US
Practice Address - Phone:646-296-4226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072716-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical