Individual provider Active NPI

Evelyn Goldstein, LCSW-C

  • Clinical Social Worker
  • Silver Spring, MD
National Provider Identifier
1013116474
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17134 Issued in MD
Practice address
11235 Oak Leaf Dr
Suite #110
Silver Spring, MD 20901-1318
Phone
(301) 681-8597
Fax
(301) 598-6648
NPI assigned
Jul 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17134 MD Primary

Addresses

Primary practice location

11235 Oak Leaf Dr
Suite #110
Silver Spring, MD 20901-1318

Mailing address

10411 Brookmoor Dr
Silver Spring, MD 20901-2603
Phone (240) 472-7045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17134MDMDPharmacist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1013116474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10411 BROOKMOOR DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209012603",
            "telephone_number": "240-472-7045",
            "fax_number": "301-681-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11235 OAK LEAF DR",
            "address_2": "SUITE #110",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011318",
            "telephone_number": "301-681-8597",
            "fax_number": "301-598-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "EVELYN",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.