Active NPI
Judith Freya Goldberg, PH.D.
- Clinical Psychologist
- Winchester, MA
National Provider Identifier
1437190642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1533
- Practice address
- 955 Main St
Suite 105
Winchester, MA 01890-1961 - Phone
- (781) 721-0663
- Fax
- (781) 729-3210
- NPI assigned
- Jun 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1533 | MA | Primary |
Addresses
Primary practice location
955 Main St
Suite 105
Winchester, MA 01890-1961
Mailing address
955 Main St
Suite 105
Winchester, MA 01890-1961
Phone (781) 721-0663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 154168 | Other | MA | MAGELLAN |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1533 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333929600000",
"number": "1437190642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 MAIN ST",
"address_2": "SUITE 105",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "018901961",
"telephone_number": "781-721-0663",
"fax_number": "781-729-3210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 MAIN ST",
"address_2": "SUITE 105",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "018901961",
"telephone_number": "781-721-0663",
"fax_number": "781-729-3210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "JUDITH",
"middle_name": "FREYA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-09",
"last_updated": "2012-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "1533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "154168",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.