Kerry Goldman
Individual provider Active NPI Clinical Social Worker · West End, NC
NPI 1962959528 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1962959528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- P010874 (NC)
- Practice address
- 980 7 Lakes Drive
West End, NC 27376 - Phone
- (910) 673-5437
- Fax
- (910) 673-5438
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P010874 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moore Pediatric Therapy Serivces | Clinical | Past | Accepting new patients |
| Moore Pediatric Therapy Serivces | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P010874 | NC | Yes |
Addresses
Primary practice location
980 7 Lakes Drive
West End, NC 27376
Mailing address
PO Box 354
West End, NC 27376-0354
Phone (910) 673-5437
Other providers in West End, NC
- Firsthealth of the Carolinas, Inc.
- Ronald David Franklin
- Ariel Gardner
- Ryan Garner
- Tracy Ann Goldberg
- Stephanie Graves
- Kimberly G Greer
- John Mark Griffies
- Emily Fancher Grimaldi
- Jason Edward Guevara
All providers in West End, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.