Healthcare Provider Details

I. General information

NPI: 1104018431
Provider Name (Legal Business Name): LAURIE WEINBERG MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5175 COLD SPRING CREAMERY RD #2
DOYLESTOWN PA
18902-6228
US

IV. Provider business mailing address

1 EVERETT DR
NEWTOWN PA
18940-1655
US

V. Phone/Fax

Practice location:
  • Phone: 215-348-9640
  • Fax: 215-348-7311
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00447700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014349
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: