Provider Demographics
NPI:1912088519
Name:GOLDSTEIN, MARSHA (LCSW, BCD)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 S IDAHO ST
Mailing Address - Street 2:PO BOX 1753
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89041-1753
Mailing Address - Country:US
Mailing Address - Phone:775-751-9579
Mailing Address - Fax:775-751-9579
Practice Address - Street 1:1961 S IDAHO ST
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89041-1753
Practice Address - Country:US
Practice Address - Phone:775-751-9579
Practice Address - Fax:775-751-9579
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2523C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical