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Individual
SOPHIA EVELYN MIMI GOLDBERG
Active
Individual
SOPHIA EVELYN MIMI GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/09/2017
Last updated
10/28/2025
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