Individual
MS. CAROL WEIDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
110-20 71ST AVE, PROFESSIONAL OFFICE #3, FOREST HILLS, NY 11375
(718) 544-3454
Mailing address
125-10 QUEENS BLVD, APT 2405, KEW GARDENS, NY 11415
(718) 544-3454
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R11905
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
337986
VALUE OPTIONS
—
Enumeration date
04/12/2007
Last updated
07/08/2007
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