Healthcare Provider Details

I. General information

NPI: 1225068380
Provider Name (Legal Business Name): SANDY WEINER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PINETOWN RD SUITE350
FT WASHINGTON PA
19034-2605
US

IV. Provider business mailing address

550 PINETOWN RD SUITE350
FT WASHINGTON PA
19034-2605
US

V. Phone/Fax

Practice location:
  • Phone: 215-643-0200
  • Fax: 215-643-9844
Mailing address:
  • Phone: 215-643-0200
  • Fax: 215-643-9844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC04655200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW015527
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: