Provider Demographics
NPI:1629421094
Name:LEIGH GOLDMAN, LCSW LLC
Entity Type:Organization
Organization Name:LEIGH GOLDMAN, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDMAN-HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-795-1222
Mailing Address - Street 1:80 SCENIC DR STE 2
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5211
Mailing Address - Country:US
Mailing Address - Phone:609-795-1222
Mailing Address - Fax:
Practice Address - Street 1:80 SCENIC DR STE 2
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5211
Practice Address - Country:US
Practice Address - Phone:609-795-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054739001041C0700X
NJ7419431041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty