Provider Demographics
NPI:1669840393
Name:GOLDENBERG, JOY (MA)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:GOLDENBERG
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:PROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1635 NE JENSEN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-7229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 NE JENSEN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-7229
Practice Address - Country:US
Practice Address - Phone:772-453-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13414868-6004101YM0800X
CA1662101YP2500X
CA109061106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional