Active NPI
Tara Ann Goldman, LCSW
- Clinical Social Worker
- Monticello, NY
National Provider Identifier
1063097103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 084515-1
- Practice address
- 22 Crystal St
Monticello, NY 12701-1323 - Phone
- (845) 794-1521
- NPI assigned
- Mar 10, 2021
- 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 | 084515-1 | NY | Primary |
Addresses
Primary practice location
22 Crystal St
Monticello, NY 12701-1323
Mailing address
4 Pommel Dr
Newburgh, NY 12550-3844
Phone (845) 564-2037
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 084515-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1063097103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 POMMEL DR",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125503844",
"telephone_number": "845-564-2037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 CRYSTAL ST",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127011323",
"telephone_number": "845-794-1521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "TARA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-10",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "084515-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.