Active NPI
Astrid Ertola, PH.D.
- Clinical Psychologist
- Goldsboro, NC
National Provider Identifier
1811349699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4741
- Practice address
- 201 Stevens Mill Rd
Goldsboro, NC 27530-1056 - Phone
- (919) 731-3560
- NPI assigned
- Jul 6, 2016
- Last updated
- Jul 6, 2016
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4741 | NC | Primary |
Addresses
Primary practice location
201 Stevens Mill Rd
Goldsboro, NC 27530-1056
Mailing address
201 Stevens Mill Rd
Goldsboro, NC 27530-1056
Phone (919) 731-3560
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4741 | NC | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467763200000",
"number": "1811349699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 STEVENS MILL RD",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275301056",
"telephone_number": "919-731-3560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 STEVENS MILL RD",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275301056",
"telephone_number": "919-731-3560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERTOLA",
"first_name": "ASTRID",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-06",
"last_updated": "2016-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
- Kingsley Enohebob Enonjang, PHARMD
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- Adrian Aryeh Epstein, M.D. PH.D.
- Erin a Smith DDS PA (Goldsboro Pediatric Dentistry & Orthodontics)
- Edward O Erkes, D.D.S.
- Daicy Esther Escorcia Perez
- Hoda Eskander, M.D.
- Benjamin D Eskra, M.D.
- Tracy Lyn Eskra, M.D.
- David Vincent Peter Espitia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.