Provider Demographics
NPI:1427126275
Name:WEINBERG, JASON M (LMSW)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:M
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:MR
Other - First Name:YONAH
Other - Middle Name:
Other - Last Name:WEINBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RABBI
Mailing Address - Street 1:1551A E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6709
Mailing Address - Country:US
Mailing Address - Phone:718-339-4459
Mailing Address - Fax:
Practice Address - Street 1:2020 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2329
Practice Address - Country:US
Practice Address - Phone:718-676-4302
Practice Address - Fax:718-676-4299
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP481941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical