Provider Demographics
NPI:1053667253
Name:GOLDRING, DEVORAH (LMSW)
Entity Type:Individual
Prefix:
First Name:DEVORAH
Middle Name:
Last Name:GOLDRING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2923
Mailing Address - Country:US
Mailing Address - Phone:516-375-3693
Mailing Address - Fax:
Practice Address - Street 1:317 GRANT AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2923
Practice Address - Country:US
Practice Address - Phone:516-375-3693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NY082461104100000X
NJ44SL05727900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator