Provider Demographics
NPI:1770680936
Name:WEITMAN, NORMA K (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:K
Last Name:WEITMAN
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 1:108 CEDAR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9425
Mailing Address - Country:US
Mailing Address - Phone:315-446-0307
Mailing Address - Fax:315-446-4379
Practice Address - Street 1:108 CEDAR HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-9425
Practice Address - Country:US
Practice Address - Phone:315-446-0307
Practice Address - Fax:315-446-4379
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO21963-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56886BMedicare ID - Type Unspecified