Mary A Goldstein, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L2874 Issued in OR

Practice address

1501 6TH St Ste C
La Grande, OR 97850-2419

Phone

(541) 963-6715

Fax

(541) 962-7440

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Winding Waters Medical ClinicGroup PAC ID 8224346713, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Winding Waters Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Enterprise, OR
  • NPI 1922475219
  Medicare reassignment Care Compare group NPD
• Winding Waters Medical Clinic

  • Community/Retail Pharmacy
  • Wallowa, OR
  • NPI 1114631322
  NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1407866213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1005",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501005",
            "telephone_number": "541-962-0162",
            "fax_number": "541-962-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 6TH ST STE C",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978502419",
            "telephone_number": "541-963-6715",
            "fax_number": "541-962-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyenne M Gillihan
• David Kristopher Glabe, O.D., M.S.
• Melyssa Gleed
• Ricky Gloria
• Holly Marie Goebel, RN
• Kyla Gomes, DPT
• Quenton Bo-Rashard Goodwin, MSW
• James Arthur Gorham, PT
• Stanley Keith Graham, M.D.
• Grande Ronde Child Center, Inc.

• Clinical Social Worker in La Grande, OR
• Providers in La Grande, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.