Provider Demographics
NPI:1922213446
Name:GOLDBERG, WILLIAM SETH (MSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SETH
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4338
Mailing Address - Country:US
Mailing Address - Phone:201-894-8515
Mailing Address - Fax:201-871-4674
Practice Address - Street 1:171 MEADOWBROOK RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4338
Practice Address - Country:US
Practice Address - Phone:201-894-8515
Practice Address - Fax:201-871-4674
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC067821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical