Active NPI
Lauren Gloria Goldbach, LCSW
- Clinical Social Worker
- Tempe, AZ
National Provider Identifier
1487091948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-16034
- Practice address
- 2120 S McClintock Dr
Ste. 105
Tempe, AZ 85282-2692 - Phone
- (480) 804-0326
- Fax
- (480) 804-0083
- NPI assigned
- May 23, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-13735 | AZ | |
| Clinical Social Worker | 1041C0700X | LCSW-16034 | AZ | Primary |
Addresses
Primary practice location
2120 S McClintock Dr
Ste. 105
Tempe, AZ 85282-2692
Mailing address
1400 E Southern Ave
Ste. 735
Tempe, AZ 85282-5691
Phone (480) 804-0326
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124988 | Medicaid | AZ |
Other names 1
- Laurrn G. Jones
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2020 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-13735 | AZ | MD | Social Worker |
| LCSW-16034 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492905600000",
"number": "1487091948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E SOUTHERN AVE",
"address_2": "STE. 735",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852825691",
"telephone_number": "480-804-0326",
"fax_number": "480-804-0083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 S MCCLINTOCK DR",
"address_2": "STE. 105",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852822692",
"telephone_number": "480-804-0326",
"fax_number": "480-804-0083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBACH",
"first_name": "LAUREN",
"middle_name": "GLORIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-23",
"last_updated": "2017-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "LMSW-13735",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW-16034",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124988",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURRN",
"last_name": "JONES",
"middle_name": "G.",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.