Healthcare Provider Details

I. General information

NPI: 1669840393
Provider Name (Legal Business Name): JOY GOLDENBERG MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOY PROSS

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 NE JENSEN BEACH BLVD
JENSEN BEACH FL
34957-7229
US

IV. Provider business mailing address

1635 NE JENSEN BEACH BLVD
JENSEN BEACH FL
34957-7229
US

V. Phone/Fax

Practice location:
  • Phone: 772-453-1072
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13414868-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1662
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT4996
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number109061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: