Provider Demographics
NPI:1073282844
Name:GOLDSTEIN, GEORGEANNA JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:GEORGEANNA
Middle Name:JEAN
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 BROAD BRANCH RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2540
Mailing Address - Country:US
Mailing Address - Phone:202-374-9241
Mailing Address - Fax:
Practice Address - Street 1:1575 PINE RIDGE RD STE 16
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2110
Practice Address - Country:US
Practice Address - Phone:239-734-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW237401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical