Organization Active NPI

Brian H. Goldman, PH.D., PC

  • Psychologist
  • Cumming, GA
National Provider Identifier
1174795298
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY002429 Issued in GA
Legal business name
BRIAN H. GOLDMAN, PH.D., PC
Practice address
347 Dahlonega St
Suite 103
Cumming, GA 30040-2406
Phone
(678) 495-6143
Fax
(678) 455-9496
NPI assigned
Mar 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Dr. Brian Hunter Goldman, PH.D.NPI 1356499685
Title
President
Phone
(678) 485-6143

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PSY002429 GA Primary

Addresses

Primary practice location

347 Dahlonega St
Suite 103
Cumming, GA 30040-2406

Mailing address

347 Dahlonega St
Suite 103
Cumming, GA 30040-2406
Phone (678) 495-6143

Other identifiers 1

IdentifierTypeStateIssuer
00895265EMedicaidGA

National Provider Directory

National Provider Directory

Locations

347 Dahlonega St
Ste 103
Cumming, GA 30040
Phone (678) 485-6143

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1174795298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 DAHLONEGA ST",
            "address_2": "SUITE 103",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402406",
            "telephone_number": "678-495-6143",
            "fax_number": "678-455-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 DAHLONEGA ST",
            "address_2": "SUITE 103",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402406",
            "telephone_number": "678-495-6143",
            "fax_number": "678-455-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN H. GOLDMAN, PH.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-485-6143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00895265E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.