Kelly Nicole Goldberg, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Marriottsville, MD
NPI 1417396367 · NPPES record last updated Jan 4, 2023
Key facts
- NPI
- 1417396367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 06454 (MD)
- Practice address
- 2500 Wallington Way
Suite 103
Marriottsville, MD 21104-1505 - Phone
- (410) 442-9791
- NPI assigned
- Jun 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06454 | MD | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 06454 | MD | Yes |
Addresses
Primary practice location
2500 Wallington Way
Suite 103
Marriottsville, MD 21104-1505
Mailing address
2500 Wallington Way
Suite 103
Marriottsville, MD 21104-1505
Phone (410) 442-9791
Other providers in Marriottsville, MD
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- Joelle L Frizzera
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- Rani Mathew George
- Hazel Denise Glasper
- Stacey Gordon
- Joanne McLane Hardesty
- Margaret Ruth Hargrove
- HCPT LLC
- Help Me Speak, LLC
All providers in Marriottsville, MD · Speech-Language Pathologist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.