Active NPI
Idell Goldenberg, PSY.D.
- Psychologist
- Marlborough, MA
National Provider Identifier
1497377378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6935-
- Practice address
- 98 Sudbury St
Marlborough, MA 01752-6748 - Phone
- (508) 878-3054
- NPI assigned
- May 13, 2020
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6935- | Primary |
Addresses
Primary practice location
98 Sudbury St
Marlborough, MA 01752-6748
Mailing address
98 Sudbury St
Marlborough, MA 01752-6748
Phone (508) 878-3054
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589328000000",
"number": "1497377378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 SUDBURY ST",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017526748",
"telephone_number": "508-878-3054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 SUDBURY ST",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017526748",
"telephone_number": "508-878-3054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDENBERG",
"first_name": "IDELL",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-13",
"last_updated": "2020-05-13",
"certification_date": "2020-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": "6935-",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.