Provider Demographics
NPI:1346397288
Name:GOLDMAN-HALL, BARRY JAY (MA, LCSW)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:JAY
Last Name:GOLDMAN-HALL
Suffix:
Gender:M
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3283 DESERTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-3522
Mailing Address - Country:US
Mailing Address - Phone:408-945-7876
Mailing Address - Fax:
Practice Address - Street 1:16264 CHURCH STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95038-0546
Practice Address - Country:US
Practice Address - Phone:408-776-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 97651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical