Goldberg, Carly L

Goldberg, Carly L is an sole proprietor health care provider with primary practice located at 1062 E Lancaster Ave Suite 15-G, Bryn Mawr PA 19010-1552. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Goldberg, Carly L can be contacted via phone (610) 930-3025.

Contact Information

Primary practice address
1062 E Lancaster Ave Suite 15-G Bryn Mawr PA 19010-1552
Phone: (610) 930-3025
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X CW016417 Pennsylvania

Profile Details

NPI number 1245413814
LBN Legal business name Goldberg, Carly L
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 6th, 2007
Last updated Sep 30th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245413814 NPPES
Pennsylvania MEDICAID 101492950 0001

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