Individual provider Active NPI

Lisa Goldberg

  • Mental Health Counselor
  • Oceanside, NY
National Provider Identifier
1023448404
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
080012-1 Issued in NY
Practice address
32 Perkins Ave
Oceanside, NY 11572-3911
Phone
(516) 992-2161
NPI assigned
Nov 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 080012-1 NY Primary

Addresses

Primary practice location

32 Perkins Ave
Oceanside, NY 11572-3911

Mailing address

32 Perkins Ave
Oceanside, NY 11572-3911
Phone (516) 992-2161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150610000438 NY Practitioner - Clinical Social Worker 6002137411 Reassigns benefits to 2 organizations
Practice locations: Oceanside, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrity Social Work Services LLCGroup PAC ID 4880609528, 74 clinicians

Practice addresses (Care Compare)

46 Francesca LN
Staten Island, NY 10303-2101
Phone (718) 494-2858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080012-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Living Behavioral Health LCSW PLLC CurrentSince Aug 5, 2018 Accepting new patients
Northeast Counseling Center Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Senior Living Behavioral Health, PLLC Past Accepting new patients

Locations

1065 Smithtown Ave
Bohemia, NY 11716
Phone (631) 388-7616

747 3rd Ave
Fl 2
New York, NY 10017
Phone (516) 387-2375

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1023448404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 PERKINS AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723911",
            "telephone_number": "516-992-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 PERKINS AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723911",
            "telephone_number": "516-992-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-20",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "080012-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.