Carly L Goldberg, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016417 Issued in PA

Practice address

1062 E Lancaster Ave
Suite 15-G
Bryn Mawr, PA 19010-1552

Phone

(610) 930-3025

NPI assigned

Dec 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1245413814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 E LANCASTER AVE",
            "address_2": "SUITE 15-G",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101552",
            "telephone_number": "610-930-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 E LANCASTER AVE",
            "address_2": "SUITE 15-G",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101552",
            "telephone_number": "610-930-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "CARLY",
        "middle_name": "L",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101492950 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael D Gober, MD
• Rodolfo I Godinez, M.D.
• Amanda Goffredo, DO
• Belinda Goins
• William Howard Gold
• Jamie Goldberg, MS, ATC
• Elizabeth S Goldman, M.D.
• Mitchell Joel Goldman, M.D.
• Benjamin Kane Goldstein, LCSW
• Rachel Melissa Goldstein, CRNP

• Clinical Social Worker in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.