Individual provider Active NPI

Danielle Beth Goldberg, MSW, LICSW, LCSW-C

  • Clinical Social Worker
  • Takoma Park, MD
National Provider Identifier
1063623288
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17049 Issued in MD
Practice address
6930 Carroll Ave
Suite 830
Takoma Park, MD 20912-4423
Phone
(202) 422-7387
NPI assigned
May 28, 2007
Last updated
Nov 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50077794 DC
Clinical Social Worker 1041C0700X 17049 MD Primary

Addresses

Primary practice location

6930 Carroll Ave
Suite 830
Takoma Park, MD 20912-4423

Mailing address

7125 Maple Ave
Takoma Park, MD 20912-4418
Phone (202) 422-7387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 6, 2022 through May 6, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC50077794DCMDClinical Social Worker
17049MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1063623288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 MAPLE AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124418",
            "telephone_number": "202-422-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 CARROLL AVE",
            "address_2": "SUITE 830",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124423",
            "telephone_number": "202-422-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "DANIELLE",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50077794",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

Verify at the official NPI Registry.