Provider Demographics
NPI:1962225276
Name:WEBER, DAVID M (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:WEBER
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 1:565 ROUTE 25A STE LR4
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2600
Mailing Address - Country:US
Mailing Address - Phone:631-248-1727
Mailing Address - Fax:
Practice Address - Street 1:565 ROUTE 25A STE LR4
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2600
Practice Address - Country:US
Practice Address - Phone:631-248-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0981221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical