Active NPI
Ina Gail Goldberg, MSW LCSWR
- Clinical Social Worker
- New York, NY
National Provider Identifier
1578747259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0428821
- Practice address
- 65 West 96TH Street
#20B
New York, NY 10025 - Phone
- (646) 544-1690
- NPI assigned
- Dec 18, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R0428821 | NY | Primary |
Addresses
Primary practice location
65 West 96TH Street
#20B
New York, NY 10025
Mailing address
25 West 75TH Street
#4A
New York, NY 10023
Phone (646) 544-1690
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 |
|---|---|---|---|
| R0428821 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197936000000",
"number": "1578747259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 WEST 75TH STREET",
"address_2": "#4A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10023",
"telephone_number": "646-544-1690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 WEST 96TH STREET",
"address_2": "#20B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10025",
"telephone_number": "646-544-1690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "INA GAIL",
"name_prefix": "Ms.",
"credential": "MSW LCSWR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-18",
"last_updated": "2007-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0428821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.