Lynnette Joy Goodman, LCSW

Individual provider Active NPI Clinical Social Worker · Fair Lawn, NJ

NPI 1063573293 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1063573293
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC00604300 (NJ)
Practice address
33-11 Broadway
Suite 206
Fair Lawn, NJ 07410-4634
Phone
(973) 772-4738
Fax
(973) 772-7965
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
44SC00604300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service of North Jersey, Inc. Past Accepting new patients
Jewish Family & Children'S Services of Northern New Jersey, Inc. Clinical Past
since Apr 30, 2018
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC00604300 NJ Yes

Addresses

Primary practice location

33-11 Broadway
Suite 206
Fair Lawn, NJ 07410-4634

Mailing address

122 Wessington Ave
Garfield, NJ 07026-3208
Phone (973) 772-4738

Other providers in Fair Lawn, NJ

All providers in Fair Lawn, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.