Provider Demographics
NPI:1487070280
Name:EVELYN GOLDSEIN LCSW-C LLC
Entity type:Organization
Organization Name:EVELYN GOLDSEIN LCSW-C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW-C
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:240-472-7045
Mailing Address - Street 1:10411 BROOKMOOR DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-2603
Mailing Address - Country:US
Mailing Address - Phone:240-472-7045
Mailing Address - Fax:301-681-8597
Practice Address - Street 1:11235 OAK LEAF DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1318
Practice Address - Country:US
Practice Address - Phone:301-681-8597
Practice Address - Fax:301-598-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty