Goldstein Neuropsychologists PC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071006006 Issued in IL

Legal business name

GOLDSTEIN NEUROPSYCHOLOGISTS PC

Doing business as

Michigan Avenue Neuropsychologists

Practice address

200 S Michigan Ave
Suite 710
Chicago, IL 60604-2402

Phone

(312) 212-1776

Fax

(312) 212-1778

NPI assigned

Jan 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Diana Susan Goldstein, PH.D., ABPP

Title

President & Ceo

Phone

(312) 212-1776

Specialties & licenses 8

Addresses

Other names 1

• Michigan Avenue Neuropsychologists Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sharlet Anderson, PH.D.

  • Clinical Neuropsychologist
  • Chicago, IL
  • NPI 1528432044
  Medicare reassignment NPD
• Rachael Ellison, PHD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1265083422
  Medicare reassignment NPD
• Kristen Michelle Klipfel, PH.D.

  • Clinical Neuropsychologist
  • Chicago, IL
  • NPI 1245853977
  Medicare reassignment NPD
• Wing Man Fong, PHD

  • Clinical Psychologist
  • Saint Louis, MO
  • NPI 1073821096

  Clinical Neuropsychologist, IL

  Medicare reassignment NPD
• Edward Rhodes, LCPC

  • Professional Counselor
  • Chicago, IL
  • NPI 1104124056
  NPD (past)
• Laura Renteria, PH.D.

  • Clinical Neuropsychologist
  • Beaverton, OR
  • NPI 1205046422
  NPD (past)
• Lisa Anne Sworowski, PH.D.

  • Clinical Neuropsychologist
  • Charlotte, NC
  • NPI 1891824306
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1063568210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MICHIGAN AVE",
            "address_2": "SUITE 710",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606042402",
            "telephone_number": "312-212-1776",
            "fax_number": "312-212-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MICHIGAN AVE",
            "address_2": "SUITE 710",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606042402",
            "telephone_number": "312-212-1776",
            "fax_number": "312-212-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDSTEIN NEUROPSYCHOLOGISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-28",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "312-212-1776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., ABPP"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071006006",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20041441A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071006006",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20041441A",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "IL",
            "license": "071006006",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "IN",
            "license": "20041441A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006006",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041441A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Avenue Neuropsychologists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jean B Goldsmith, PHD
• Morgan Goldsmith, APRN, PNP-AC
• Rachel Goldsmith, LMFT
• Rachel Evelyn Goldsmith, PH.D.
• Goldstein Emotion-Focused Therapy LLC
• Amy L Goldstein, PT
• Audrey Goldstein
• Brittany Goldstein, MD
• Courtney Goldstein, LPC
• Deborah Goldstein, A.P.N.

• Clinical Neuropsychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.