Kenneth J Goldberg, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

001507 Issued in MO

Practice address

15431 Pickett CT
Chesterfield, MO 63017-2427

Phone

(314) 614-4393

NPI assigned

Feb 19, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1972196947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15431 PICKETT CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172427",
            "telephone_number": "314-614-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15431 PICKETT CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172427",
            "telephone_number": "314-614-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "001507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Global Psychiatric Associates Inc
• Georgina Glogovac, MD
• Pamela Mae Glowczwski
• Susan Ann Godwin, D.M.D.
• Susan Marie Gogel
• Richard Goldberg, D.M.D.
• Steven Marc Goldberg, O.D.
• John Lewis Golden, D.C.
• Joseph K Goldenberg, MD
• Sarah G Goldkamp, AUD

• Clinical Social Worker in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.