Active NPI
Susan J Goldberg, MA
- Psychologist
- Northville, MI
National Provider Identifier
1770197717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P506433
- Practice address
- 442 Randolph St
Northville, MI 48167-1465 - Phone
- (248) 514-5277
- NPI assigned
- Sep 8, 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 | P506433 | MI | Primary |
Addresses
Primary practice location
442 Randolph St
Northville, MI 48167-1465
Mailing address
442 Randolph St
Northville, MI 48167-1465
Phone (248) 514-5277
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P506433 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1770197717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "442 RANDOLPH ST",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481671465",
"telephone_number": "248-514-5277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "442 RANDOLPH ST",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481671465",
"telephone_number": "248-514-5277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MI",
"license": "P506433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.