Individual provider Active NPI

Patricia Joyce Goodman, PSY.D.

  • Clinical Psychologist
  • Ardsley, NY
National Provider Identifier
1568526481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014775 Issued in NY
Practice address
547 Saw Mill River Rd
Suite 2F
Ardsley, NY 10502-2143
Phone
(914) 714-2263
Fax
(914) 693-0210
NPI assigned
Dec 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 014775 NY Primary

Addresses

Primary practice location

547 Saw Mill River Rd
Suite 2F
Ardsley, NY 10502-2143

Mailing address

143 Beacon Hill Dr
#H23
Dobbs Ferry, NY 10522-2461
Phone (914) 714-2263

Other identifiers 1

IdentifierTypeStateIssuer
02195628MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
014775NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568526481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 BEACON HILL DR",
            "address_2": "#H23",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105222461",
            "telephone_number": "914-714-2263",
            "fax_number": "914-693-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 SAW MILL RIVER RD",
            "address_2": "SUITE 2F",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105022143",
            "telephone_number": "914-714-2263",
            "fax_number": "914-693-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "PATRICIA",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02195628",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardsley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.