Active NPI
Jo Anne Goldman, MSW LICSW
- Clinical Social Worker
- Medford, MA
National Provider Identifier
1376618488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1018384
- Practice address
- 84 High Street
Medford, MA 02155 - Phone
- (787) 391-6222
- Fax
- (797) 391-6119
- NPI assigned
- Nov 22, 2006
- 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 | 1018384 | MA | Primary |
Addresses
Primary practice location
84 High Street
Medford, MA 02155
Mailing address
84 High Street
Medford, MA 02155
Phone (781) 391-6222
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P05778 | Other | MA | BC |
| 937501 | Other | PACIFIC CARE | |
| 146334 | Other | MAGELLAN BEHAVIORAL HEALT | |
| 002273 | Other | VALUE OPTIONS | |
| 723059 | Other | MA | TUFTS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1018384 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1376618488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 HIGH STREET",
"city": "MEDFORD",
"state": "MA",
"postal_code": "02155",
"telephone_number": "781-391-6222",
"fax_number": "781-391-6119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 HIGH STREET",
"city": "MEDFORD",
"state": "MA",
"postal_code": "02155",
"telephone_number": "787-391-6222",
"fax_number": "797-391-6119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "JO",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "MSW LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1018384",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC",
"identifier": "P05778",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFIC CARE",
"identifier": "937501",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "146334",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "002273",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "723059",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.