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General NPI Number Information
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NPI Number | 1477063212
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Entity Type | Organization
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Legal Business Name | DANIEL GOLDMAN, LCSW, LLC
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/09/2017
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Provider Practice Location Address
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Address Line | 1906 MONROE ST
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City | MADISON
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State | WI
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Zip | 53711-2027
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Country | US
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Telephone | 608-886-4839
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Fax |
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Provider Business Mailing Address
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Address Line | 1906 MONROE ST
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City | MADISON
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State | WI
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Zip | 53711-2027
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Country | US
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Telephone | 608-886-4839
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL GOLDMAN
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Credential | LCSW
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Telephone | 608-886-4839
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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 | 7545-123
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License Number State | WI
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