Provider Demographics
NPI:1841354636
Name:GOODMAN, SHARON B (MSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:B
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 AVENUE AT THE COMMONS
Mailing Address - Street 2:
Mailing Address - City:SHREWBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702
Mailing Address - Country:US
Mailing Address - Phone:732-842-2535
Mailing Address - Fax:732-842-2598
Practice Address - Street 1:200 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1732
Practice Address - Country:US
Practice Address - Phone:732-842-2535
Practice Address - Fax:732-842-2598
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004484001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ640604Medicare ID - Type Unspecified