Provider Demographics
NPI:1871834655
Name:GOLDSTEIN, DANIEL A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 SCALES ST APT C
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-2461
Mailing Address - Country:US
Mailing Address - Phone:734-358-2981
Mailing Address - Fax:
Practice Address - Street 1:1422 SCALES ST APT C
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-2461
Practice Address - Country:US
Practice Address - Phone:734-358-2981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0086171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical