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NPI Code Detail

MEDICARE: DANIELLE TOBIAS GOLDMAN LCSW

MEDICARE: DANIELLE TOBIAS GOLDMAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerIL
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1538731526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE TOBIAS GOLDMAN LCSW
Provider Business Mailing Address
First Line : 677 WILMOT RD
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-3956
Country : US
Telephone Number : 847-702-1702
Fax Number :
Provider Business Practice Location Address
First Line : 1137 MCHENRY RD
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-1377
Country : US
Telephone Number : 847-807-8777
Fax Number : 847-503-0828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2021
Last Update Date : 09/15/2023

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