Individual provider Active NPI

Rachel Goldman, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1487148854
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022244 Issued in NY
Practice address
302 5TH Ave
11TH Floor, #1112
New York, NY 10001
Phone
(646) 609-6323
NPI assigned
Jun 19, 2018
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY29980 CA
Clinical Psychologist 103TC0700X 022244 NY Primary

Addresses

Primary practice location

302 5TH Ave
11TH Floor, #1112
New York, NY 10001

Mailing address

PO Box 330094
San Francisco, CA 94133-0094

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

LicenseStateTypeSpecialty
PSY29980CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1487148854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330094",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941330094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 5TH AVE",
            "address_2": "11TH FLOOR, #1112",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "646-609-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2023-02-01",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29980",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.

Verify at the official NPI Registry.