Individual provider Active NPI

Jenna Goldstein-Walsh, LMSW-CC

  • Social Worker
  • Lewiston, ME
National Provider Identifier
1497036818
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
MC13149 Issued in ME
Practice address
25 Westminster St
Lewiston, ME 04240-3531
Phone
(207) 786-8122
Fax
(207) 786-8164
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MC13149 ME Primary

Addresses

Primary practice location

25 Westminster St
Lewiston, ME 04240-3531

Mailing address

25 Westminster St
Lewiston, ME 04240-3531
Phone (207) 786-8122

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

LicenseStateTypeSpecialty
MC13149MEMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1497036818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WESTMINSTER ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042403531",
            "telephone_number": "207-786-8122",
            "fax_number": "207-786-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WESTMINSTER ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042403531",
            "telephone_number": "207-786-8122",
            "fax_number": "207-786-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN-WALSH",
        "first_name": "JENNA",
        "credential": "LMSW-CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "MC13149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.