Mary Ellen Goetz, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS015355 Issued in PA

Practice address

146 Montgomery Ave Ste 146
Bala Cynwyd, PA 19004-2956

Phone

(610) 306-4908

Fax

(610) 667-6421

NPI assigned

Oct 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1316126113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 MONTGOMERY AVE STE 146",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042956",
            "telephone_number": "610-306-4908",
            "fax_number": "610-667-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 MONTGOMERY AVE STE 146",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042956",
            "telephone_number": "610-306-4908",
            "fax_number": "610-667-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZ",
        "first_name": "MARY ELLEN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven B. Glazier, MA
• Morgan Glenn, BCBA
• Avram Louis Glickman
• GLTT Diagnostics LLC
• Edward Joseph Goebel, M.D.
• David N Goldberg, D.O.
• Debbie Goldberg, P.T.
• Jeffrey William Goldfine, D.D.S.
• Carol Goldman, DACM
• Rochelle H. Goldman

• Clinical Psychologist in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.