Individual provider Active NPI

Amy Beth Goldstein, PH.D.

  • Clinical Psychologist
  • Auburndale, MA
National Provider Identifier
1619032604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2960 Issued in MA
Practice address
192 Grove St
Auburndale, MA 02466-2257
Phone
(617) 965-4353
Fax
(617) 965-4353
NPI assigned
Dec 27, 2006
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 2960 MA Primary

Addresses

Primary practice location

192 Grove St
Auburndale, MA 02466-2257

Mailing address

192 Grove St
Auburndale, MA 02466-2257
Phone (617) 965-4353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060223000082 MA Practitioner - Clinical Psychologist 1052327426 Practice locations: Auburndale, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

192 Grove St
Auburndale, MA 02466-2257
Phone (617) 965-4353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619032604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 GROVE ST",
            "city": "AUBURNDALE",
            "state": "MA",
            "postal_code": "024662257",
            "telephone_number": "617-965-4353",
            "fax_number": "617-965-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 GROVE ST",
            "city": "AUBURNDALE",
            "state": "MA",
            "postal_code": "024662257",
            "telephone_number": "617-965-4353",
            "fax_number": "617-965-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "AMY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburndale, MA

Sources for this page

Verify at the official NPI Registry.