Provider Demographics
NPI:1912063918
Name:GOLDSCHMIDT, MARIA I
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:I
Last Name:GOLDSCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:IOLOB
Other - Last Name:GOLDSCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:16 BEECHWOOD PARK
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5205
Mailing Address - Country:US
Mailing Address - Phone:845-454-4531
Mailing Address - Fax:
Practice Address - Street 1:1081 MAIN ST
Practice Address - Street 2:SUITE F
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3504
Practice Address - Country:US
Practice Address - Phone:845-897-4600
Practice Address - Fax:845-897-4604
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO245291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
135945OtherVALUE OPTIONS
617530OtherMVP
P2626116OtherOXFORD
135945OtherVALUE OPTIONS