Provider Demographics
NPI:1386742385
Name:WINEBURGH, ALAN LEWIS (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:LEWIS
Last Name:WINEBURGH
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 1:295 CENTRAL PARK WEST
Mailing Address - Street 2:OFFICE 4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:212-362-2617
Mailing Address - Fax:914-591-5823
Practice Address - Street 1:295 CENTRAL PARK WEST
Practice Address - Street 2:OFFICE 4A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-362-2617
Practice Address - Fax:914-591-5823
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR23782103T00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
N30151Medicare ID - Type Unspecified