Individual provider Active NPI

Jolie Golomb, LCSW,LICSW

  • Clinical Social Worker
  • Bethesda, MD
National Provider Identifier
1659485910
Registry record updated Dec 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09277 Issued in MD
Practice address
4405 E West Hwy
Suite 506
Bethesda, MD 20814-4522
Phone
(301) 961-9220
Fax
(301) 656-2998
NPI assigned
Aug 17, 2006
Last updated
Dec 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC302937 DC
Clinical Social Worker 1041C0700X 09277 MD Primary
Clinical Social Worker 1041C0700X RO30051-1 NY

Addresses

Primary practice location

4405 E West Hwy
Suite 506
Bethesda, MD 20814-4522

Mailing address

5129 Scarsdale Rd
Bethesda, MD 20816-2320
Phone (301) 320-3719

Other identifiers 1

IdentifierTypeStateIssuer
840581600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091102000218 DC Practitioner - Clinical Social Worker 4688711104 Practice locations: Bethesda, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4405 E W Hwy
Suite 506
Bethesda, MD 20814-4586
Phone (301) 961-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO30051-1NYMDClinical Social Worker
09277MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291420800000",
    "number": "1659485910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5129 SCARSDALE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208162320",
            "telephone_number": "301-320-3719",
            "fax_number": "301-565-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 E WEST HWY",
            "address_2": "SUITE 506",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144522",
            "telephone_number": "301-961-9220",
            "fax_number": "301-656-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOMB",
        "first_name": "JOLIE",
        "name_prefix": "Ms.",
        "credential": "LCSW,LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC302937",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09277",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO30051-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "840581600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.