NPIMap

Organization Active NPI

Little Silver Behavioral Health, LLC

  • Clinical Psychologist
  • Little Silver, NJ
National Provider Identifier
1508353137
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00345400 Issued in NJ
Legal business name
LITTLE SILVER BEHAVIORAL HEALTH, LLC
Practice address
34 Sycamore Ave BLDG 2
Little Silver, NJ 07739-1228
Phone
(732) 576-8925
Fax
(732) 576-8814
NPI assigned
Apr 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Authorized official

Name
Dr. David Michael Goldberg, PH,D,NPI 1417009697
Title
President
Phone
(732) 576-8925

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 35SI00345400 NJ Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 44SL05240800 NJ

Addresses

Primary practice location

34 Sycamore Ave BLDG 2
Little Silver, NJ 07739-1228

Mailing address

34 Sycamore Ave BLDG 2
Little Silver, NJ 07739-1228
Phone (732) 576-8925

Other identifiers 1

IdentifierTypeStateIssuer
0584746MedicaidNJ

National Provider Directory

National Provider Directory

Locations

34 Sycamore Ave
Bldg 2
Little Silver, NJ 07739
Phone (732) 576-8925

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1508353137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE AVE BLDG 2",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391228",
            "telephone_number": "732-576-8925",
            "fax_number": "732-576-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE AVE BLDG 2",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391228",
            "telephone_number": "732-576-8925",
            "fax_number": "732-576-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE SILVER BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-576-8925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH,D,"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00345400",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL05240800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0584746",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Silver, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.