MEDICARE: LAURA GRACE GOLDBERG MSW, LSW

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	104100000X	Social Worker	SW141129	PA

General Provider Information

NPI Number	:	1679326714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA GRACE GOLDBERG MSW, LSW

Provider Business Mailing Address
First Line	:	1011 BINGHAM ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2516 JANE ST STE AND205
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2216
Country	:	US
Telephone Number	:	724-374-3468
Fax Number	:

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

Provider Enumeration Date	:	04/09/2024
Last Update Date	:	02/20/2026

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