MEDICARE: JOY GOLDENBERG MA

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
1	101YM0800X	Mental Health Counselor	13414868-6004	UT
2	101YP2500X	Professional Counselor	1662	CA
3	106H00000X	Marriage & Family Therapist	MT4996	FL
4	106H00000X	Marriage & Family Therapist	109061	CA

General Provider Information

NPI Number	:	1669840393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY GOLDENBERG MA

Provider Business Mailing Address
First Line	:	1635 NE JENSEN BEACH BLVD
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-7229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 NE JENSEN BEACH BLVD
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-7229
Country	:	US
Telephone Number	:	772-453-1072
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2015
Last Update Date	:	09/02/2025

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