MARJORIE PROVOST GOLDBAUM LICSW LADC NPI 1407869704

NPI Information

  • NPI: 1407869704
  • Provider Name: MARJORIE PROVOST GOLDBAUM, LICSW LADC
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 201 CHELMSFORD ST
    CHELMSFORD, MA
    ZIP 01824
  • Phone: (978) 256-1467

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NPI Details

Marjorie Provost Goldbaum, LICSW LADC is a clinical social worker in Chelmsford, MA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Marjorie Provost Goldbaum, LICSW LADC NPI is 1407869704. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

201 CHELMSFORD ST
CHELMSFORD, MA
ZIP 01824-359
Phone: (978) 256-1467
Fax: (978) 256-7465

The enumeration date for this NPI number is 8/15/2006 and was last updated on 2/2/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)1530MASSACHUSETTSNo
21041C0700XSocial WorkerClinical110711MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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