Active NPI
Olga Goldengorn, CASAC
- Addiction (Substance Use Disorder) Counselor
- Brooklyn, NY
National Provider Identifier
1396049813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 20566
- Practice address
- 1300 Avenue P
Brooklyn, NY 11229-1106 - Phone
- (718) 954-3800
- Fax
- (718) 954-3767
- NPI assigned
- Dec 23, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20566 | NY | Primary |
Addresses
Primary practice location
1300 Avenue P
Brooklyn, NY 11229-1106
Mailing address
9954 63Rd Ave
Rego Park, NY 11374-1943
Phone (718) 459-5738
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 |
|---|---|---|---|
| 20566 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293062400000",
"number": "1396049813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9954 63RD AVE",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113741943",
"telephone_number": "718-459-5738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 AVENUE P",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112291106",
"telephone_number": "718-954-3800",
"fax_number": "718-954-3767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDENGORN",
"first_name": "OLGA",
"credential": "CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-23",
"last_updated": "2010-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "20566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.