Ann Marie Goelitz, PHD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P061788-1 Issued in NY

Practice address

272 N Bedford Rd
Ste 204
Mount Kisco, NY 10549-1168

Phone

(646) 265-5028

NPI assigned

Jun 4, 2007

Last updated

Sep 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 7, 2022 through Mar 7, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1376745059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 656",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068770656",
            "telephone_number": "646-265-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 N BEDFORD RD",
            "address_2": "STE 204",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105491168",
            "telephone_number": "646-265-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOELITZ",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P061788-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A300017156",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexa Giuliani, PA-C
• Gracie B Glast, L.P.N.
• Global Empire Care LLC
• Alexandria J Glover
• Barbara Godlewska
• Lawrence Edward Goettisheim, DDS
• Eugene Nicholas Goetz, DMD
• Barbara Goldblum, M.D.
• Trudie Goldmann, PH. D.
• Amy Jill Goldstein, LCSW

• Clinical Social Worker in Mount Kisco, NY
• Providers in Mount Kisco, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.