Provider Demographics
NPI:1053495358
Name:GOLDIN, LORRAINE SUSAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:SUSAN
Last Name:GOLDIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 SOLANO AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2306
Mailing Address - Country:US
Mailing Address - Phone:415-455-8925
Mailing Address - Fax:
Practice Address - Street 1:1861 SOLANO AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2306
Practice Address - Country:US
Practice Address - Phone:415-455-8925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS11309101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health