Active NPI
Judith Gail Goldman, MSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1194982108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PR0226771
- Practice address
- 24 E 12TH St
#2A-F
New York, NY 10003 - Phone
- (212) 255-3792
- Fax
- (212) 966-4216
- NPI assigned
- May 19, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PR0226771 | NY | Primary |
| Clinical Social Worker | 1041C0700X | 44SC00753100 | NJ |
Addresses
Primary practice location
24 E 12TH St
#2A-F
New York, NY 10003
Mailing address
24 East 12TH St
#2A-F
New York, NY 10003
Phone (212) 255-3792
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 |
|---|---|---|---|
| 44SC00753100 | NJ | MD | Clinical Social Worker |
| PR0226771 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248912000000",
"number": "1194982108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 EAST 12TH ST",
"address_2": "#2A-F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10003",
"telephone_number": "212-255-3792",
"fax_number": "212-966-4216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 E 12TH ST",
"address_2": "#2A-F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10003",
"telephone_number": "212-255-3792",
"fax_number": "212-966-4216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "JUDITH",
"middle_name": "GAIL",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-19",
"last_updated": "2009-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PR0226771",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC00753100",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.