Active NPI
Taryn Goldberg, PHD, NCSP
- Psychologist
- Apex, NC
National Provider Identifier
1326795121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY11243
- Practice address
- 2311 Energy Dr BLDG 9
Apex, NC 27502-4343 - Phone
- (984) 254-5635
- Fax
- (317) 520-8200
- NPI assigned
- Mar 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY11243 | FL | Primary |
Addresses
Primary practice location
2311 Energy Dr BLDG 9
Apex, NC 27502-4343
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other practice location 1
3301 College Ave
Davie, FL 33314-7721
Phone (954) 262-7089
Other practice location 2
6909 Old Highway 441 S Ste 119
Mount Dora, FL 32757-7039
Phone (352) 358-5001
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY11243 | FL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopebridge LLC | Psychologist | 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": "1646179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1326795121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 DEPAUW BLVD STE 3070",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462686135",
"telephone_number": "855-324-0885",
"fax_number": "317-520-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2311 ENERGY DR BLDG 9",
"city": "APEX",
"state": "NC",
"postal_code": "275024343",
"telephone_number": "984-254-5635",
"fax_number": "317-520-8200"
}
],
"practiceLocations": [
{
"address_1": "3301 College Ave",
"address_purpose": "LOCATION",
"city": "Davie",
"state": "FL",
"postal_code": "333147721",
"country_code": "US",
"telephone_number": "954-262-7089",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6909 Old Highway 441 S Ste 119",
"address_purpose": "LOCATION",
"city": "Mount Dora",
"state": "FL",
"postal_code": "327577039",
"country_code": "US",
"telephone_number": "352-358-5001",
"fax_number": "317-520-8200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLDBERG",
"first_name": "TARYN",
"name_prefix": "Dr.",
"credential": "PHD, NCSP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-02",
"last_updated": "2023-03-20",
"certification_date": "2023-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY11243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apex, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.