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Organization
WESTSIDE BEHAVIORAL HEALTH, LLC
Active
Organization
WESTSIDE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STEPHEN WEINER LICSW (PARTENER)
(508) 580-4611
Entity
Organization
Contact information
Practice address
7 CHRISTY DRIVE, SUITE 3, BROCKTON, MA 02301
(508) 580-4611
(508) 580-4404
Mailing address
7 CHRISTY DRIVE, SUITE 3, BROCKTON, MA 02301
(508) 580-4611
(508) 580-4404
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
7330
MA
103T00000X
Psychologist
8177
MA
1041C0700X
Clinical Social Worker
1027200
MA
1041C0700X
Clinical Social Worker
104590
MA
1041C0700X
Clinical Social Worker
Primary
105028
MA
1041C0700X
Clinical Social Worker
110746
MA
163WP0808X
Psychiatric/Mental Health Registered Nurse
90943
MA
163WP0808X
Psychiatric/Mental Health Registered Nurse
94523
MA
2084P0800X
Psychiatry Physician
35081
MA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
135140
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P10235
BLUE CROSS GROUP NUMBER
MA
Enumeration date
01/26/2007
Last updated
04/20/2008
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