Active NPI
Kenneth Ardell Golden Sr., L.M.S.W.
- Social Worker
- Teaneck, NJ
National Provider Identifier
1912464470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 072114
- Practice address
- 1485 Endicott Ter
Teaneck, NJ 07666-6031 - Phone
- (646) 717-1219
- NPI assigned
- Feb 20, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 072114 | NY | Primary |
Addresses
Primary practice location
1485 Endicott Ter
Teaneck, NJ 07666-6031
Mailing address
1485 Endicott Ter
Teaneck, NJ 07666-6031
Phone (646) 717-1219
Other practice location 1
1485 Endicott Ter
Teaneck, NJ 07666-6031
Phone (646) 717-1219
Other practice location 2
4277 65th Pl
Woodside, NY 11377-5054
Phone (718) 429-2000 ext. 7024
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
| License | State | Type | Specialty |
|---|---|---|---|
| 072114 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1912464470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1485 ENDICOTT TER",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076666031",
"telephone_number": "646-717-1219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 ENDICOTT TER",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076666031",
"telephone_number": "646-717-1219"
}
],
"practiceLocations": [
{
"address_1": "1485 Endicott Ter",
"address_purpose": "LOCATION",
"city": "Teaneck",
"state": "NJ",
"postal_code": "076666031",
"country_code": "US",
"telephone_number": "646-717-1219",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4277 65th Pl",
"address_purpose": "LOCATION",
"city": "Woodside",
"state": "NY",
"postal_code": "113775054",
"country_code": "US",
"telephone_number": "718-429-2000 x7024",
"fax_number": "718-334-0057",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLDEN",
"first_name": "KENNETH",
"middle_name": "ARDELL",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "L.M.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-20",
"last_updated": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "NY",
"license": "072114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Teaneck, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.