Provider Demographics
NPI:1528146222
Name:WEISBORD, JOANN P (LCSW)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:P
Last Name:WEISBORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 CENTRAL AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1205
Mailing Address - Country:US
Mailing Address - Phone:516-295-4442
Mailing Address - Fax:516-295-3195
Practice Address - Street 1:999 CENTRAL AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1205
Practice Address - Country:US
Practice Address - Phone:516-295-4442
Practice Address - Fax:516-295-3195
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033911-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical