Individual provider Active NPI

Robert McGoldrick, LCSW

  • Mental Health Counselor
  • Elizabethtown, NY
National Provider Identifier
1184712796
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R033410-1 Issued in NY
Practice address
7513 Court Street
Elizabethtown, NY 12932
Phone
(518) 873-3670
Fax
(578) 873-3777
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R033410-1 NY Primary

Addresses

Primary practice location

7513 Court Street
Elizabethtown, NY 12932

Mailing address

7513 Court Street
Elizabethtown, NY 12932
Phone (518) 873-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20190708000534 NY Practitioner - Clinical Social Worker 4284969767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Essex County TreasurerGroup PAC ID 1658392600, 16 clinicians

Practice addresses (Care Compare)

7513 Court St
Elizabethtown, NY 12932-0008
Phone (518) 873-3670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R033410-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Essex County Treasurer CurrentSince May 30, 2019 Accepting new patients
Essex County Treasurer Mental Health CurrentSince May 30, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184712796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7513 COURT STREET",
            "city": "ELIZABETHTOWN",
            "state": "NY",
            "postal_code": "12932",
            "telephone_number": "518-873-3670",
            "fax_number": "578-873-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7513 COURT STREET",
            "city": "ELIZABETHTOWN",
            "state": "NY",
            "postal_code": "12932",
            "telephone_number": "518-873-3670",
            "fax_number": "578-873-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOLDRICK",
        "first_name": "ROBERT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R033410-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, NY

Sources for this page

Verify at the official NPI Registry.