Provider Demographics
NPI:1396508610
Name:GOLDMAN, CHRISTINE ANNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANNE
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:ANNE
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:211 SADDLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15071-3721
Mailing Address - Country:US
Mailing Address - Phone:610-823-0050
Mailing Address - Fax:
Practice Address - Street 1:211 SADDLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-3721
Practice Address - Country:US
Practice Address - Phone:610-823-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0182871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical