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Organization
JG THERAPY LLC
Active
Organization
JG THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN GOLDMANN LICSW (MEMBER)
(781) 862-9482
Entity
Organization
Contact information
Practice address
79 NORTH ST, LEXINGTON, MA 02420-1811
(781) 862-9482
Mailing address
79 NORTH ST, LEXINGTON, MA 02420-1811
(781) 862-9482
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101397
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629117056
BLUE CROSS BLUE SHIELD INDIVIDUAL NPI GIVEN TO SOLE PROVIDER IN JG THERAPY LLC
MA
01
—
P01571
LEGACY # FOR INDIVIDUAL PROVIDER IN JG THERAPY LLC
MA
Enumeration date
08/17/2012
Last updated
08/17/2012
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