Active NPI
Rick G Goldman, LCSW
- Clinical Social Worker
- Idaho Falls, ID
National Provider Identifier
1174766448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-32181
- Practice address
- 3385 Potomac Way
Idaho Falls, ID 83404-4978 - Phone
- (208) 542-7159
- Fax
- (208) 522-2767
- NPI assigned
- Apr 15, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-29004 | ID | |
| Clinical Social Worker | 1041C0700X | LCSW-32181 | ID | Primary |
Addresses
Primary practice location
3385 Potomac Way
Idaho Falls, ID 83404-4978
Mailing address
2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 542-7159
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-29004 | ID | MD | Social Worker |
| LCSW-32181 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542153600000",
"number": "1174766448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 CORONADO ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047407",
"telephone_number": "208-542-7159",
"fax_number": "208-522-2767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3385 POTOMAC WAY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834044978",
"telephone_number": "208-542-7159",
"fax_number": "208-522-2767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "RICK",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-15",
"last_updated": "2018-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-29004",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-32181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.