Jean R Goldberg, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R015304 Issued in NY

Practice address

817 Broadway
North Suite Room 9 9TH Floor
New York, NY 10003

Phone

(212) 645-6443

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tried and True Nutrition, Inc.

  • Registered Dietitian
  • New York, NY
  • NPI 1073990263
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1053519108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SEVENTH AVENUE",
            "address_2": "APARTMENT 15V",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "212-989-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 BROADWAY",
            "address_2": "NORTH SUITE ROOM 9 9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-645-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JEAN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R015304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATION DEPT DIVISION",
            "identifier": "R015304",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ilana Lesser Goldberg, M.A.
• Ina Gail Goldberg, MSW LCSWR
• Ira Jay Goldberg, M.D.
• Jacqueline Goldberg, LMSW
• Jane G Goldberg, PH.D.
• Jenna Dey Goldberg, M.D.
• Jessica Goldberg, APRN
• Jessica Dawn Goldberg, M.A. CCC SLP
• Jessica Parker Goldberg, LCSW
• Jill Dana Goldberg, MS, RD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.