Individual provider Active NPI

Sherry Lynn Goldman, LCSW

  • Psychologist
  • Toms River, NJ
National Provider Identifier
1760527964
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
44SC05201900 Issued in NJ
Practice address
892 Common Way
Suite H
Toms River, NJ 08721
Phone
(732) 557-0354
Fax
(732) 286-4334
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 44SC05201900 NJ Primary

Addresses

Primary practice location

892 Common Way
Suite H
Toms River, NJ 08721

Mailing address

712 E Long Branch Avenue
Bayville, NJ 08721
Phone (732) 557-0354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050506000038 NJ Practitioner - Clinical Social Worker 6103866454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

124 Clinton PL
Neptune, NJ 07753-5819
Phone (732) 557-0354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05201900NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Bungalo Limited Liability Company Psychologist CurrentSince Jan 3, 2005 Accepting new patients

Locations

892 Commons Way
Ste H
Toms River, NJ 08755
Phone (609) 390-3188

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760527964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 E LONG BRANCH AVENUE",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "08721",
            "telephone_number": "732-557-0354",
            "fax_number": "732-286-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 COMMON WAY",
            "address_2": "SUITE H",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08721",
            "telephone_number": "732-557-0354",
            "fax_number": "732-286-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "SHERRY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "44SC05201900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

Verify at the official NPI Registry.