Active NPI
Suzanne Shrader Goldenberg, MSW, L.I.C.S.W
- Clinical Social Worker
- Cranston, RI
National Provider Identifier
1457484818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISWO1549
- Practice address
- 1421 Narragansett Blvd
Cranston, RI 02905-5140 - Phone
- (401) 467-0765
- Fax
- (401) 467-0765
- NPI assigned
- Mar 14, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISWO1549 | RI | Primary |
Addresses
Primary practice location
1421 Narragansett Blvd
Cranston, RI 02905-5140
Mailing address
1421 Narragansett Blvd
Cranston, RI 02905-5140
Phone (401) 467-0765
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27350-5 | Other | RI | BLUE CROSS BLUE SHIELD |
| SG5134 | Medicaid | RI | |
| 1038120 | Other | RI | BEACON HEALTH STATEGIES |
| 411607 | Other | RI | BLUECHIP |
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 |
|---|---|---|---|
| ISWO1549 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1457484818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 NARRAGANSETT BLVD",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029055140",
"telephone_number": "401-467-0765",
"fax_number": "401-467-0765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 NARRAGANSETT BLVD",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029055140",
"telephone_number": "401-467-0765",
"fax_number": "401-467-0765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDENBERG",
"first_name": "SUZANNE",
"middle_name": "SHRADER",
"name_prefix": "Ms.",
"credential": "MSW, L.I.C.S.W",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISWO1549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "27350-5",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SG5134",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH STATEGIES",
"identifier": "1038120",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECHIP",
"identifier": "411607",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.