Provider Demographics
NPI:1992310734
Name:WEISBERG, TEHILA (LCSW)
Entity type:Individual
Prefix:
First Name:TEHILA
Middle Name:
Last Name:WEISBERG
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 1:450 W KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1269
Mailing Address - Country:US
Mailing Address - Phone:732-901-6001
Mailing Address - Fax:
Practice Address - Street 1:415 CAREY ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1747
Practice Address - Country:US
Practice Address - Phone:732-901-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical