Physician Compare National (NPI:1609880343)

HEALTHCARE PROVIDER: LOUIE ANN GOLDBERG LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1609880343
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759602568
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150604002973
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOLDBERG
	Individual professional last name
Provider First Name	LOUIE
	Individual professional first name
Provider Middle Name	ANN
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	255 W STEWART AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	MEDFORD
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	975013600
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5419447331
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y