Healthcare Provider Details

I. General information

NPI: 1942346382
Provider Name (Legal Business Name): STEVEN WEINSTEIN L.M.H.C.,L.M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEVEN WEINSTEIN M.A.

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 BOSTON AVE
MEDFORD MA
02155-3522
US

IV. Provider business mailing address

86 BOSTON AVE
MEDFORD MA
02155-3522
US

V. Phone/Fax

Practice location:
  • Phone: 781-488-3613
  • Fax: 781-483-2221
Mailing address:
  • Phone: 781-488-3613
  • Fax: 781-483-2221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number229
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: