Individual provider Active NPI

Lawrence Mark Goldberg, LCSW

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1346417680
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW4053 Issued in FL
Practice address
21 Columbia St Ste 201
Orlando, FL 32806-1133
Phone
(407) 262-2220
Fax
(407) 834-5011
NPI assigned
May 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW4053 FL Primary

Addresses

Primary practice location

21 Columbia St Ste 201
Orlando, FL 32806-1133

Mailing address

21 Columbia St Ste 201
Orlando, FL 32806-1133
Phone (407) 262-2220

Other practice location 1

1871 Wentwood Cove
Lake Mary, FL 32746-1808
Phone (407) 416-2523

Other identifiers 1

IdentifierTypeStateIssuer
117630100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150810001414 FL Practitioner - Clinical Social Worker 5991010688 Reassigns benefits to 4 organizations
I20260513000113 NV Practitioner - Clinical Social Worker 5991010688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

21 Columbia St
Suite 201
Orlando, FL 32806-1133
Phone (407) 262-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW4053FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Mar 1, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Jun 14, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

21 Columbia St
Ste 201
Orlando, FL 32806
Phone (321) 841-0746

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Interoperability endpoints

  • Direct secure messaging: lawrencegoldberg@tdh.allscriptsdirect.net

Organizations & group practices 6

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1346417680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COLUMBIA ST STE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061133",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COLUMBIA ST STE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061133",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1871 Wentwood Cove",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327461808",
            "country_code": "US",
            "telephone_number": "407-416-2523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "LAWRENCE",
        "middle_name": "MARK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117630100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.