Ellyn Laura Goldstein, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

GA. LCSW 0930 Issued in GA

Practice address

1260 Concord Rd SE
Suite 102
Smyrna, GA 30080-5306

Phone

(770) 434-1878

Fax

(770) 434-5009

NPI assigned

Mar 16, 2007

Sex

Female

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 GA

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

Specialty

Clinical Social Worker

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154445252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 CONCORD RD SE",
            "address_2": "SUITE 102",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805306",
            "telephone_number": "770-434-1878",
            "fax_number": "770-434-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 CONCORD RD SE",
            "address_2": "SUITE 102",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805306",
            "telephone_number": "770-434-1878",
            "fax_number": "770-434-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "ELLYN",
        "middle_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "GA. LCSW 0930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Taylor Gilstad, D.C.
• Andro Giorgadze, MD
• Kendra Gipson, WHNP
• Global Care Centers, Inc.
• Jessica Rose Goergen, MSN, FNP-C
• Martin I Goldstein, M.D.
• Daniel P Golightly Jr., MD
• Jami Michele Gomarko, D.C.
• Seleztino Gonzalez
• Goodlife Cardiac Care, LLC

• Mental Health Counselor in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.