Provider Demographics
NPI:1952935199
Name:GOLDMAN, DANIEL LOUIS (LMSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LOUIS
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-4453
Mailing Address - Country:US
Mailing Address - Phone:803-917-5633
Mailing Address - Fax:
Practice Address - Street 1:848 OHIO ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-4453
Practice Address - Country:US
Practice Address - Phone:803-917-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11322104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker