Individual provider Active NPI

Alyssa Johanna Goldberg, LCSW

  • Clinical Social Worker
  • Jersey City, NJ
National Provider Identifier
1023773116
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06362700 Issued in NJ
Practice address
100 Hoboken Ave Apt 327
Jersey City, NJ 07310-1158
Phone
(443) 690-6613
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 44SC06362700 NJ Primary

Addresses

Primary practice location

100 Hoboken Ave Apt 327
Jersey City, NJ 07310-1158

Mailing address

100 Hoboken Ave Apt 327
Jersey City, NJ 07310-1158
Phone (443) 690-6613

Other practice location 1

8 Hillside Ave Ste 105
Montclair, NJ 07042-2129
Phone (551) 227-7556

Other practice location 2

300 Forest Ave
Paramus, NJ 07652-5429
Phone (551) 227-7556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC Single Specialty PastSince Jul 17, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1023773116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOBOKEN AVE APT 327",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073101158",
            "telephone_number": "443-690-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOBOKEN AVE APT 327",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073101158",
            "telephone_number": "443-690-6613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Hillside Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070422129",
            "country_code": "US",
            "telephone_number": "551-227-7556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076525429",
            "country_code": "US",
            "telephone_number": "551-227-7556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "ALYSSA",
        "middle_name": "JOHANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06362700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.