Active NPI
Henchi Goldberg
- Clinical Social Worker
- Montclair, NJ
National Provider Identifier
1306310958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC05716100
- Practice address
- 31 S Fullerton Ave
Montclair, NJ 07042-3455 - Phone
- (973) 768-8000
- NPI assigned
- Jan 16, 2019
- Last updated
- Jan 16, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05716100 | NJ | Primary |
Addresses
Primary practice location
31 S Fullerton Ave
Montclair, NJ 07042-3455
Mailing address
355 Brook Ave
Passaic, NJ 07055-2425
Phone (973) 768-8000
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 |
|---|---|---|---|
| 44SC05716100 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1306310958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 BROOK AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070552425",
"telephone_number": "973-768-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 S FULLERTON AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070423455",
"telephone_number": "973-768-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "HENCHI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05716100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.