Individual provider Active NPI

Alex Leland Goldberg, MSW, LGSW

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1992225452
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
22815 Issued in MD
Practice address
14 S Broadway
Baltimore, MD 21231-1712
Phone
(410) 276-1773
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 22815 MD Primary

Addresses

Primary practice location

14 S Broadway
Baltimore, MD 21231-1712

Mailing address

14 S Broadway
Baltimore, MD 21231-1712
Phone (410) 276-1773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992225452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311712",
            "telephone_number": "410-276-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311712",
            "telephone_number": "410-276-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "ALEX",
        "middle_name": "LELAND",
        "credential": "MSW, LGSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "22815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.