NPIMap

Organization Active NPI

Grand Strand Psychological Services, PA

  • Clinical Neuropsychologist
  • Myrtle Beach, SC
National Provider Identifier
1295957678
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
SC845 Issued in SC
Legal business name
GRAND STRAND PSYCHOLOGICAL SERVICES, PA
Practice address
4882 Socastee Blvd
Myrtle Beach, SC 29588-7245
Phone
(843) 294-4500
Fax
(843) 294-4503
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Authorized official

Name
Dr. Leonard Goldschmidt, J.D., PSY.D.NPI 1336364892
Title
President
Phone
(843) 294-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103G00000X SC845 SC Primary

Addresses

Primary practice location

4882 Socastee Blvd
Myrtle Beach, SC 29588-7245

Mailing address

4882 Socastee Blvd
Myrtle Beach, SC 29588-7245
Phone (843) 294-4500

National Provider Directory

National Provider Directory

Locations

11943 Grandhaven Dr
Ste B
Murrells Inlt, SC 29576
Phone (843) 353-6125

11947 Grandhaven Dr
Ste N
Murrells Inlt, SC 29576
Phone (843) 652-4600

4882 Socastee Blvd
Myrtle Beach, SC 29588
Phone (843) 294-4500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1295957678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4882 SOCASTEE BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887245",
            "telephone_number": "843-294-4500",
            "fax_number": "843-294-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4882 SOCASTEE BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887245",
            "telephone_number": "843-294-4500",
            "fax_number": "843-294-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND STRAND PSYCHOLOGICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "GOLDSCHMIDT",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-294-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "J.D., PSY.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "SC",
            "license": "SC845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.