Individual provider Active NPI

Elisabeth Eugenia Goldenberg, MSW, QMHP

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1801924253
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L5871 Issued in OR
Practice address
2440 Willamette St Ste 201
Eugene, OR 97405-3170
Phone
(541) 321-2278
Fax
(541) 246-8826
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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 L5871 OR Primary

Addresses

Primary practice location

2440 Willamette St Ste 201
Eugene, OR 97405-3170

Mailing address

4059 Donald St Apt J
Eugene, OR 97405-3971
Phone (541) 517-2517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20160727002408 OR Practitioner - Clinical Social Worker 6204129224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arise Counseling Service LLCGroup PAC ID 5496104473, 22 clinicians

Practice addresses (Care Compare)

2440 Willamette St
Suite 201
Eugene, OR 97405-3170
Phone (541) 321-2278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L5871ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arise Counseling Service, LLC. Dba Northlight Counseling Clinical CurrentSince Jan 1, 2024 Accepting new patients
Options Counseling Services of Oregon CurrentSince Jun 1, 2016 Accepting new patients
Inner Room Somatic Therapy, LLC Past Accepting new patients

Locations

360 E 10th Ave
Ste 450
Eugene, OR 97401

1255 Pearl St
Ste 102
Eugene, OR 97401

1075 Washington St
Eugene, OR 97401
Phone (541) 321-2278

2440 Willamette St
Ste 201
Eugene, OR 97405
Phone (541) 234-3090

11010 SE Division St
Ste 202
Portland, OR 97266
Phone (503) 335-5975

3085 River Rd N
Salem, OR 97303
Phone (541) 321-2278

2645 Portland Rd NE
Ste 120
Salem, OR 97301

Organizations & group practices 3

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1801924253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4059 DONALD ST APT J",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974053971",
            "telephone_number": "541-517-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 WILLAMETTE ST STE 201",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974053170",
            "telephone_number": "541-321-2278",
            "fax_number": "541-246-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "ELISABETH",
        "middle_name": "EUGENIA",
        "name_prefix": "Ms.",
        "credential": "MSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.