Individual
CARLY L GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1062 E LANCASTER AVE, SUITE 15-G, BRYN MAWR, PA 19010-1552
(610) 930-3025
Mailing address
1062 E LANCASTER AVE, SUITE 15-G, BRYN MAWR, PA 19010-1552
(610) 930-3025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW016417
PA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101492950 0001
—
PA
Enumeration date
12/06/2007
Last updated
09/30/2010
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