Individual provider Active NPI

Pamela Joy Klein Goldman

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1487729216
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103869 Issued in MA
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

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
P02196OtherMABC BS

Other names 1

  • Pamela Joy Klein Other name

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
Green means eligible to order or refer.
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

LicenseStateTypeSpecialty
103869MAMDClinical 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

Verify at the official NPI Registry.