Individual provider Active NPI

Janice E Goldstein, PHD

  • Psychologist
  • North Andover, MA
National Provider Identifier
1306952452
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3093 Issued in MA
Practice address
565 Turnpike St
#81
North Andover, MA 01845
Phone
(978) 682-1579
Fax
(978) 689-4582
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3093 MA Primary

Addresses

Primary practice location

565 Turnpike St
#81
North Andover, MA 01845

Mailing address

565 Turnpike St
#81
North Andover, MA 01845
Phone (978) 682-1579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061228000183 MA Practitioner - Clinical Psychologist 6709886658 Practice locations: North Andover, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

565 Turnpike St
North Andover, MA 01845-5936
Phone (978) 682-1579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3093MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Andover Counseling Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306952452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 TURNPIKE ST",
            "address_2": "#81",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-682-1579",
            "fax_number": "978-689-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 TURNPIKE ST",
            "address_2": "#81",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-682-1579",
            "fax_number": "978-689-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JANICE",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.