Active NPI
Leslie Marcia Goldstein, LCSW, BCD
- Clinical Social Worker
- New York, NY
National Provider Identifier
1013065895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0179701
- Practice address
- 180 W End Ave
1A
New York, NY 10023-4902 - Phone
- (212) 362-8626
- Fax
- (212) 721-7476
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R0179701 | NY | Primary |
Addresses
Primary practice location
180 W End Ave
1A
New York, NY 10023-4902
Mailing address
180 W End Ave
1A
New York, NY 10023-4902
Phone (212) 362-8626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2013 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0179701 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288051200000",
"number": "1013065895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 W END AVE",
"address_2": "1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100234902",
"telephone_number": "212-362-8626",
"fax_number": "212-721-7476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 W END AVE",
"address_2": "1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100234902",
"telephone_number": "212-362-8626",
"fax_number": "212-721-7476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "LESLIE",
"middle_name": "MARCIA",
"name_prefix": "Ms.",
"credential": "LCSW, BCD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2010-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0179701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.