Glenn D. Goldman, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3059 Issued in OR

Practice address

2045 SE Hawthorne Blvd
Portland, OR 97214-3819

Phone

(503) 926-7034

NPI assigned

Feb 6, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1083953350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 NE 60TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972134018",
            "telephone_number": "503-939-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143819",
            "telephone_number": "503-926-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "GLENN",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Goldfarb, CADC 1
• Michelle Goldfeder, RN, BSN, NC-BC
• Charles Samuel Goldfoot
• Bruce E. Goldman, O.D.
• Clifford Goldman
• Jamie Lee Goldman
• Mark Adam Goldman, MD
• Rachel E Goldman, MOT, OTR/L
• Robert Kenneth Goldman, MD
• Sara Anne Goldman, LPC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.