Provider Demographics
NPI:1023228616
Name:WEISENSEEL, CONSTANCE COTTER (MSW)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:COTTER
Last Name:WEISENSEEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:CONSTANCE
Other - Middle Name:M
Other - Last Name:COTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:12 E 86TH ST
Mailing Address - Street 2:# 1124
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0506
Mailing Address - Country:US
Mailing Address - Phone:212-396-3597
Mailing Address - Fax:
Practice Address - Street 1:12 E 86TH ST
Practice Address - Street 2:# 1124
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0506
Practice Address - Country:US
Practice Address - Phone:212-396-3597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027833-11041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist