Provider Demographics
NPI:1902942477
Name:GOLDMAN NOTIS, AMY J (MSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:GOLDMAN NOTIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7682
Mailing Address - Country:US
Mailing Address - Phone:617-731-1511
Mailing Address - Fax:
Practice Address - Street 1:1330 BEACON ST STE 349
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3204
Practice Address - Country:US
Practice Address - Phone:617-852-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1053001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical