Provider Demographics
NPI:1063623288
Name:GOLDBERG, DANIELLE BETH (MSW, LICSW, LCSW-C)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:BETH
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4418
Mailing Address - Country:US
Mailing Address - Phone:202-422-7387
Mailing Address - Fax:
Practice Address - Street 1:6930 CARROLL AVE
Practice Address - Street 2:SUITE 830
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4423
Practice Address - Country:US
Practice Address - Phone:202-422-7387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500777941041C0700X
MD170491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical