Individual provider Active NPI

Daniel Goldberg, PHD

  • Clinical Psychologist
  • Princeton, NJ
National Provider Identifier
1629439997
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2059 Issued in NJ
Practice address
601 Ewing St Ste C9
Princeton, NJ 08540-2756
Phone
(609) 683-8000
NPI assigned
Mar 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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 2059 NJ Primary

Addresses

Primary practice location

601 Ewing St Ste C9
Princeton, NJ 08540-2756

Mailing address

601 Ewing St Ste C9
Princeton, NJ 08540-2756
Phone (609) 683-8000

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
2059NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1629439997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 EWING ST STE C9",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402756",
            "telephone_number": "609-683-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EWING ST STE C9",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402756",
            "telephone_number": "609-683-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "DANIEL",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "2059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.