Provider Demographics
NPI:1497815591
Name:GOLDBERG, HELEN (LICENSED CLINICAL SO)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 WEST END AVENUE
Mailing Address - Street 2:1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3207
Mailing Address - Country:US
Mailing Address - Phone:212-877-0544
Mailing Address - Fax:212-877-0544
Practice Address - Street 1:525 WEST END AVENUE
Practice Address - Street 2:1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3207
Practice Address - Country:US
Practice Address - Phone:212-877-0544
Practice Address - Fax:212-877-0544
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR00868211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N24751Medicare ID - Type Unspecified