Provider Demographics
NPI:1376609859
Name:GOLDBERG, KAREN S (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:S
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12017 KERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2815
Mailing Address - Country:US
Mailing Address - Phone:301-680-9060
Mailing Address - Fax:
Practice Address - Street 1:12017 KERWOOD RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2815
Practice Address - Country:US
Practice Address - Phone:301-680-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD047181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical