Provider Demographics
NPI:1346988664
Name:GREENWALD, GOLDIE RENEE (LMSW)
Entity Type:Individual
Prefix:
First Name:GOLDIE
Middle Name:RENEE
Last Name:GREENWALD
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 1:12662 OLD WICK CIR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1936
Mailing Address - Country:US
Mailing Address - Phone:505-386-7667
Mailing Address - Fax:
Practice Address - Street 1:500 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3916
Practice Address - Country:US
Practice Address - Phone:505-386-7667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107601104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker