Individual provider Active NPI

Laurie Goldfarb, PHD

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1417378522
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016852-1 Issued in NY
Practice address
3512 Quentin Rd
Brooklyn, NY 11234-4244
Phone
(718) 854-8370
NPI assigned
Dec 17, 2013
Last updated
Dec 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 016852-1 NY Primary

Addresses

Primary practice location

3512 Quentin Rd
Brooklyn, NY 11234-4244

Mailing address

3512 Quentin Rd
Brooklyn, NY 11234-4244
Phone (718) 854-8370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140116001431 NY Practitioner - Clinical Psychologist 0244468395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

250 Beach 17TH St
Far Rockaway, NY 11691-4420
Phone (800) 275-3243

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016852-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Dec 18, 2013 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Dec 18, 2013 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 420-1934

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1417378522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344244",
            "telephone_number": "718-854-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344244",
            "telephone_number": "718-854-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "LAURIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016852-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.