Provider Demographics
NPI:1548923550
Name:GOLDBERG, BILHA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BILHA
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 KING ST
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3812
Mailing Address - Country:US
Mailing Address - Phone:914-238-5332
Mailing Address - Fax:914-238-5332
Practice Address - Street 1:780 KING ST
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3812
Practice Address - Country:US
Practice Address - Phone:914-238-5332
Practice Address - Fax:914-238-5332
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-17
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL015125102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty