Active NPI
Michael B Goldman, LPC CRADC CEAP PCGC
- Counselor
- Glenview, IL
National Provider Identifier
1295070209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 178.004029
- Practice address
- 22 Mulberry CT
Glenview, IL 60025-3348 - Phone
- (847) 832-9500
- Fax
- (847) 832-9530
- NPI assigned
- Dec 2, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178.004029 | IL | Primary |
Addresses
Primary practice location
22 Mulberry CT
Glenview, IL 60025-3348
Mailing address
22 Mulberry CT
Glenview, IL 60025-3348
Phone (847) 832-9500
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 |
|---|---|---|---|
| 178.004029 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354406400000",
"number": "1295070209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 MULBERRY CT",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600253348",
"telephone_number": "847-832-9500",
"fax_number": "847-832-9530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 MULBERRY CT",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600253348",
"telephone_number": "847-832-9500",
"fax_number": "847-832-9530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "MICHAEL",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "LPC CRADC CEAP PCGC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-02",
"last_updated": "2012-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "178.004029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.