Alex J Weinstock, MSW
Individual provider Active NPI Mental Health Counselor · Brockton, NY
NPI 1205104064 · NPPES record last updated Dec 8, 2011
Key facts
- NPI
- 1205104064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1115 West Chestnut Street
Brockton, NY 02301 - Phone
- (508) 588-5751
- NPI assigned
- Dec 8, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1115 West Chestnut Street
Brockton, NY 02301
Mailing address
1709 Stearns Hill Road
Waltham, MA 02451-3344
Phone (203) 313-2278
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.