Active NPI
Dara Goldberg, LCSW-C
- Clinical Social Worker
- Bethesda, MD
National Provider Identifier
1407140965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14017
- Practice address
- 4853 Cordell Ave
Suite PH 12
Bethesda, MD 20814-7055 - Phone
- (301) 908-2643
- NPI assigned
- Jun 1, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 14017 | MD | Primary |
| Clinical Social Worker | 1041C0700X | LCD50078971 | DC |
Addresses
Primary practice location
4853 Cordell Ave
Suite PH 12
Bethesda, MD 20814-7055
Mailing address
4853 Cordell Ave
Suite PH 12
Bethesda, MD 20814-7055
Phone (301) 908-2643
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 |
|---|---|---|---|
| LCD50078971 | DC | MD | Clinical Social Worker |
| 14017 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306886400000",
"number": "1407140965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4853 CORDELL AVE",
"address_2": "SUITE PH 12",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208147055",
"telephone_number": "301-908-2643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4853 CORDELL AVE",
"address_2": "SUITE PH 12",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208147055",
"telephone_number": "301-908-2643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "DARA",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-01",
"last_updated": "2011-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "14017",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LCD50078971",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.