Active NPI
Pamela Joy Klein Goldman
- Clinical Social Worker
- Brockton, MA
National Provider Identifier
1487729216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 103869
- Practice address
- 1350 Belmont Street
Suite #107
Brockton, MA 02301-4430 - Phone
- (508) 584-9161
- Fax
- (508) 584-9463
- NPI assigned
- Nov 20, 2006
- 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 | 103869 | MA | Primary |
Addresses
Primary practice location
1350 Belmont Street
Suite #107
Brockton, MA 02301-4430
Mailing address
1350 Belmont Street
Suite #107
Brockton, MA 02301-4430
Phone (508) 584-9161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P02196 | Other | MA | BC BS |
Other names 1
- Pamela Joy Klein
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 Jul 1, 2014 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103869 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379376000000",
"number": "1487729216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 BELMONT STREET",
"address_2": "SUITE #107",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023014430",
"telephone_number": "508-584-9161",
"fax_number": "508-584-9463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 BELMONT STREET",
"address_2": "SUITE #107",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023014430",
"telephone_number": "508-584-9161",
"fax_number": "508-584-9463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "PAMELA",
"middle_name": "JOY KLEIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2013-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "103869",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS",
"identifier": "P02196",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PAMELA",
"last_name": "KLEIN",
"middle_name": "JOY",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.