Individual provider Active NPI

Rebecca Helene Goldstein, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1245908458
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
109175 Issued in NY
Practice address
1475 Park Ave
New York, NY 10029-3810
Phone
(862) 330-8025
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 109175 NY Primary

Addresses

Primary practice location

1475 Park Ave
New York, NY 10029-3810

Mailing address

1475 Park Ave
New York, NY 10029-3810
Phone (862) 330-8025

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

LicenseStateTypeSpecialty
109175NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Center for Child Development, Inc. PastSince Sep 10, 2023 Accepting new patients
Northside Center for Child Development Day School PastSince Sep 10, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1245908458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293810",
            "telephone_number": "862-330-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293810",
            "telephone_number": "862-330-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "REBECCA",
        "middle_name": "HELENE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109175",
            "primary": true
        }
    ],
    "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 Sep 6, 2023; 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.