Organization Active NPI

Gold Coast Psychological Services, PC

  • Psychologist
  • Jersey City, NJ
National Provider Identifier
1184518664
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
GOLD COAST PSYCHOLOGICAL SERVICES, PC
Practice address
220 9TH St Ste 2041
Jersey City, NJ 07302-4288
Phone
(201) 733-4277
NPI assigned
Jun 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Dr. Miriam Burt, PSYDNPI 1467711218
Title
President
Phone
(201) 477-8193

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: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

220 9TH St Ste 2041
Jersey City, NJ 07302-4288

Mailing address

220 9TH St
Ste 282
Jersey City, NJ 07302-4288
Phone (201) 477-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250902000837 NJ Part B Supplier - Clinic/Group Practice 4385145267 Receives reassigned benefits from 1 practitioner
Practice locations: Jersey City, NJ

National Provider Directory

National Provider Directory

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": "1749254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1184518664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 9TH ST",
            "address_2": "STE 282",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024288",
            "telephone_number": "201-477-0095",
            "fax_number": "201-353-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 9TH ST STE 2041",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024288",
            "telephone_number": "201-733-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-07",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "BURT",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-477-8193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.