Provider Demographics
NPI:1861829889
Name:GOLDSTEIN, DANIEL ADAM (LMSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ADAM
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9620 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-2436
Mailing Address - Country:US
Mailing Address - Phone:917-386-9772
Mailing Address - Fax:
Practice Address - Street 1:9620 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-2436
Practice Address - Country:US
Practice Address - Phone:917-386-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047936-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical