Healthcare Provider Details

I. General information

NPI: 1649299116
Provider Name (Legal Business Name): JOAN WEINFELD WING LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 GREEN ST
CAMBRIDGE MA
02139-2953
US

IV. Provider business mailing address

703 GREEN ST
CAMBRIDGE MA
02139-2953
US

V. Phone/Fax

Practice location:
  • Phone: 978-887-9793
  • Fax:
Mailing address:
  • Phone: 978-887-9793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101950
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: