Provider Demographics
NPI:1497244560
Name:GOLDBERG, VERA (MA)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CUMMINGS CTR STE 407S
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6184
Mailing Address - Country:US
Mailing Address - Phone:603-996-1702
Mailing Address - Fax:
Practice Address - Street 1:900 CUMMINGS CTR STE 407S
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6184
Practice Address - Country:US
Practice Address - Phone:781-990-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health