Provider Demographics
NPI:1477606390
Name:GOLDSMITH, RONALD A (ACSW, DCSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:A
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:ACSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 ALCAZAR ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7108
Mailing Address - Country:US
Mailing Address - Phone:505-232-9516
Mailing Address - Fax:505-232-9516
Practice Address - Street 1:1216 ALCAZAR ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7108
Practice Address - Country:US
Practice Address - Phone:505-232-9516
Practice Address - Fax:505-232-9516
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-050781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical