Individual provider Active NPI

Ellen R Goldsmith, MA, MSW, LCSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1366658262
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14676 Issued in CA
Practice address
6615 E Pacific Coast Hwy
Suite 190
Long Beach, CA 90803-4211
Phone
(562) 708-6778
Fax
(562) 431-1852
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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 14676 CA Primary

Addresses

Primary practice location

6615 E Pacific Coast Hwy
Suite 190
Long Beach, CA 90803-4211

Mailing address

6615 E Pacific Coast Hwy
Suite 190
Long Beach, CA 90803-4211
Phone (562) 708-6778

Other identifiers 1

IdentifierTypeStateIssuer
14676OtherCALCSW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130116000017 CA Practitioner - Clinical Social Worker 0547413940 Practice locations: Ventura, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

416 Shamrock Dr
Ventura, CA 93003-1044
Phone (562) 621-2882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Ellen R Goldsmith, LCSW, Professional Corporation Clinical PastSince Oct 20, 2012 Accepting new patients

Organizations & group practices 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1366658262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 E PACIFIC COAST HWY",
            "address_2": "SUITE 190",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034211",
            "telephone_number": "562-708-6778",
            "fax_number": "562-431-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 E PACIFIC COAST HWY",
            "address_2": "SUITE 190",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034211",
            "telephone_number": "562-708-6778",
            "fax_number": "562-431-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "ELLEN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MA, MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "14676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "14676",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.