Provider Demographics
NPI:1184246431
Name:GOLDENBERG, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GOLDENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1305 MORGAN STANLEY AVE UNIT 416
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1964
Mailing Address - Country:US
Mailing Address - Phone:772-342-8960
Mailing Address - Fax:
Practice Address - Street 1:2700 WESTHALL LN STE 207
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7478
Practice Address - Country:US
Practice Address - Phone:800-840-2528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-09
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical