Individual
MS. ANN MARIE GOELITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LCSW
Contact information
Practice address
272 N BEDFORD RD, STE 204, MOUNT KISCO, NY 10549-1168
(646) 265-5028
Mailing address
PO BOX 656, RIDGEFIELD, CT 06877-0656
(646) 265-5028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P061788-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A300017156
MEDICARE PTAN
NY
Enumeration date
06/04/2007
Last updated
09/28/2020
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