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General NPI Number Information
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NPI Number | 1740341031
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Entity Type | Individual
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Provider Name | RAQUEL WEINUM LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 109 W 27TH ST STE 5S
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City | NEW YORK
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State | NY
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Zip | 10001-0265
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Country | US
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Telephone | 332-230-4572
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24449
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City | NEW YORK
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State | NY
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Zip | 10087-0589
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Country | US
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Telephone | 833-351-8255
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TPSW3391
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8998
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 078309
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License Number State | NY
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