Provider Demographics
NPI:1356573737
Name:GOODMAN, MARGARET Y (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:Y
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 MORICHES RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1367
Mailing Address - Country:US
Mailing Address - Phone:516-380-9273
Mailing Address - Fax:866-662-5671
Practice Address - Street 1:564 MORICHES RD
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1367
Practice Address - Country:US
Practice Address - Phone:516-380-9273
Practice Address - Fax:866-662-5671
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0826431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00659412Medicaid