Individual
CRAIG B WIENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D
Contact information
Practice address
48 CEDAR ST., WORCESTER, MA 00109-0010
(508) 756-4825
(508) 792-3519
Mailing address
87 WILLIAM ST, SOCIAL SERVICES, WORCESTER, MA 01609-2136
(508) 756-4825
(508) 860-7990
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2580
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300050
—
MA
01
—
042485308
NETWORK HEALTH-GROUP
MA
01
—
0508977
MEDICAID
MA
01
—
052178000
MAGELLAN BEHAVIORAL HEALT
MA
01
—
1001040
BEAON HEALTH STATEGIES
MA
01
—
1001250
BEACON-GROUP
MA
05
—
1300709
—
MA
01
—
24846
CIGNA
MA
01
—
716664
TUFTS HEALTH PLAN
MA
01
—
986777801
NETWORK HEALTH
MA
01
—
W02706
BLUE CROSS BLUE SHIELD
MA
01
—
W10560
BCBS
MA
01
—
Y10141
BCBS-GROUP
MA
Enumeration date
08/21/2006
Last updated
02/05/2019
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