Individual provider Active NPI

Sara Ellen Goold

  • Psychoanalyst
  • New York, NY
National Provider Identifier
1255514857
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
000781 Issued in NY
Practice address
275 Madison Ave Ste 629
New York, NY 10016-1155
Phone
(203) 247-9305
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X
Psychoanalysis Psychologist 103TP0814X 000781 NY
Psychoanalyst 102L00000X 000781 NY Primary

Addresses

Primary practice location

275 Madison Ave Ste 629
New York, NY 10016-1155

Mailing address

53 Wellsford Dr
Goshen, CT 06756-1817
Phone (203) 247-9305

Other identifiers 1

IdentifierTypeStateIssuer
N615LIOtherNYBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000781NYMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1255514857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 WELLSFORD DR",
            "city": "GOSHEN",
            "state": "CT",
            "postal_code": "067561817",
            "telephone_number": "203-247-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MADISON AVE STE 629",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161155",
            "telephone_number": "203-247-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLD",
        "first_name": "SARA",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NY",
            "license": "000781",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "000781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "N615LI",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.