NPIMap

Organization Active NPI

Dr Stanley and Pearl Goodman JFS of Broward County Inc

  • Clinical Social Worker
  • Davie, FL
National Provider Identifier
1760463236
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DR STANLEY AND PEARL GOODMAN JFS OF BROWARD COUNTY INC
Practice address
5890 S Pine Island Rd Ste 201
Davie, FL 33328-5936
Phone
(954) 370-2140
Fax
(954) 916-1252
NPI assigned
Nov 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Mr. Randy Coleman
Title
President & Ceo
Phone
(954) 370-2140

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

5890 S Pine Island Rd Ste 201
Davie, FL 33328-5936

Mailing address

5890 S Pine Island Rd Ste 201
Davie, FL 33328-5936
Phone (954) 370-2140

Other practice location 1

7171 N University Dr Ste 207
Tamarac, FL 33321-2902
Phone (954) 909-0888

Other names 1

  • Jewish Family Service Inc of Broward County Florida Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041025000675 FL Part B Supplier - Clinic/Group Practice 1850352618 Receives reassigned benefits from 5 practitioners
Practice locations: Coral Springs, FL; Davie, FL; Tamarac, FL

National Provider Directory

National Provider Directory

Locations

11555 Heron Bay Blvd
Fl 2
Coral Springs, FL 33076
Phone (954) 909-0888

5890 S Pine Island Rd
Ste 201
Davie, FL 33328
Phone (954) 370-2140

100 S Pine Island Rd
Ste 230
Plantation, FL 33324
Phone (954) 370-2140

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1760463236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5890 S PINE ISLAND RD STE 201",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285936",
            "telephone_number": "954-370-2140",
            "fax_number": "954-916-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 S PINE ISLAND RD STE 201",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285936",
            "telephone_number": "954-370-2140",
            "fax_number": "954-916-1252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7171 N University Dr Ste 207",
            "address_purpose": "LOCATION",
            "city": "Tamarac",
            "state": "FL",
            "postal_code": "333212902",
            "country_code": "US",
            "telephone_number": "954-909-0888",
            "fax_number": "954-916-1252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR STANLEY AND PEARL GOODMAN JFS OF BROWARD COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "954-370-2140",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jewish Family Service Inc of Broward County Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.