Provider Demographics
NPI:1861569808
Name:WEINBERG, SUSAN (LICSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WATER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSATONIC
Mailing Address - State:MA
Mailing Address - Zip Code:01236-9761
Mailing Address - Country:US
Mailing Address - Phone:413-274-0006
Mailing Address - Fax:
Practice Address - Street 1:333 EAST ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5312
Practice Address - Country:US
Practice Address - Phone:413-629-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1024550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA94172OtherCIGNA BEHAVIORAL HEALTH
MAP08376OtherBLUE CROSS BLUE SHIELD
MA028054OtherVALUE OPTIONS
MA31643OtherHEALTH NEW ENGLAND
MA31643OtherHEALTH NEW ENGLAND