Individual provider Active NPI

James McIntyre Goldberg, LCSW

  • Clinical Social Worker
  • Chapel Hill, NC
National Provider Identifier
1790436368
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015508 Issued in NC
Practice address
117 Polks Landing Rd
Chapel Hill, NC 27516-8955
Phone
(919) 526-0425
NPI assigned
Jan 14, 2022
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C015508 NC Primary

Addresses

Primary practice location

117 Polks Landing Rd
Chapel Hill, NC 27516-8955

Mailing address

117 Polks Landing Rd
Chapel Hill, NC 27516-8955
Phone (919) 450-8417

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
C015508NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Casey Mental Health Collaborative PLLC Clinical PastSince Sep 29, 2024 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1790436368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 POLKS LANDING RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275168955",
            "telephone_number": "919-450-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 POLKS LANDING RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275168955",
            "telephone_number": "919-526-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JAMES",
        "middle_name": "MCINTYRE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-14",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.