IndividualActive
Jeremiah Goldberg, LCSW
NPI 1679905889 · Clinical Social Worker · Kirtland Afb, NM
Provider details
- NPI number
- 1679905889
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- CW018748 (PA)
Mailing address
2050a 2nd St Se
Kirtland Afb, NM 87117-5901
Registry dates
- Enumerated
- 2013-07-30
- Last updated
- 2021-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.