Provider Demographics
NPI:1730667122
Name:GOLDHABER, REEVE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:REEVE
Middle Name:
Last Name:GOLDHABER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 BEVERLY RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3158
Mailing Address - Country:US
Mailing Address - Phone:617-469-3800
Mailing Address - Fax:617-469-3801
Practice Address - Street 1:271 BEVERLY RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3158
Practice Address - Country:US
Practice Address - Phone:617-469-3800
Practice Address - Fax:617-469-3801
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA100081104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty