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General NPI Number Information
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NPI Number | 1447413133
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Entity Type | Organization
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Legal Business Name | RICHARD I. GOLDBERG, LLC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 7315 WISCONSIN AVE SUITE 235 EAST
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City | BETHESDA
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State | MD
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Zip | 20814-3202
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Country | US
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Telephone | 301-652-7792
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Fax |
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Provider Business Mailing Address
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Address Line | 7315 WISCONSIN AVE SUITE 235 EAST
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City | BETHESDA
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State | MD
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Zip | 20814-3202
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Country | US
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Telephone | 301-652-7792
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD I GOLDBERG
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Credential | LCSW-C
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Telephone | 301-652-7792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 02591
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License Number State | MD
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