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General NPI Number Information
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NPI Number | 1992410740
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Entity Type | Individual
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Provider Name | GENE GOLDENBERG LMSW
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Gender | Male
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 1720 EAST 14TH STREET
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 347-779-2473
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Fax |
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Provider Business Mailing Address
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Address Line | 915 EAST 7TH STREET APARTMENT 6C
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City | BROOKLYN
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State | NY
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Zip | 11230
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Country | US
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Telephone | 646-338-0763
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11400601
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License Number State | NY
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