Provider Demographics
NPI:1316085780
Name:WINEINGER, MAX ALAN (ATR-BC, CPAT, LMFT)
Entity type:Individual
Prefix:MR
First Name:MAX
Middle Name:ALAN
Last Name:WINEINGER
Suffix:
Gender:M
Credentials:ATR-BC, CPAT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-2032
Mailing Address - Country:US
Mailing Address - Phone:502-222-3777
Mailing Address - Fax:502-222-3734
Practice Address - Street 1:1421 MORTON AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-2032
Practice Address - Country:US
Practice Address - Phone:502-222-3777
Practice Address - Fax:502-222-3734
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0441106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist