Active NPI
Michael Joseph Goldfarb, LICSW
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1093949083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13705
- Practice address
- 3001 Hennepin Ave S
#B301
Minneapolis, MN 55408-2647 - Phone
- (612) 825-3440
- Fax
- (612) 827-2477
- NPI assigned
- May 6, 2009
- Sex
- Male
- 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 | 13705 | MN | Primary |
Addresses
Primary practice location
3001 Hennepin Ave S
#B301
Minneapolis, MN 55408-2647
Mailing address
3001 Hennepin Ave S
#B301
Minneapolis, MN 55408-2647
Phone (612) 825-3440
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 |
|---|---|---|---|
| 13705 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241568000000",
"number": "1093949083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 HENNEPIN AVE S",
"address_2": "#B301",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082647",
"telephone_number": "612-825-3440",
"fax_number": "612-827-2477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 HENNEPIN AVE S",
"address_2": "#B301",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082647",
"telephone_number": "612-825-3440",
"fax_number": "612-827-2477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDFARB",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-06",
"last_updated": "2009-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "13705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.