Provider Demographics
NPI:1255882643
Name:WEINBERG, MICHELLE ILANA (MS, CGC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ILANA
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COLUMBUS CIR
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1412
Mailing Address - Country:US
Mailing Address - Phone:212-664-9323
Mailing Address - Fax:
Practice Address - Street 1:5 COLUMBUS CIR
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1412
Practice Address - Country:US
Practice Address - Phone:212-664-9323
Practice Address - Fax:212-664-9341
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional