Psychological Services of St. Louis, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2010030791 Issued in MO

Legal business name

PSYCHOLOGICAL SERVICES OF ST. LOUIS, LLC

Practice address

7110 Oakland Ave
Suite 105
Richmond Heights, MO 63117-1868

Phone

(314) 884-0779

Fax

(314) 227-9327

NPI assigned

Aug 1, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gregory A Goldman, PH.D.NPI 1952634347

Title

Co-Owner

Phone

(314) 884-8075

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory A Goldman, PH.D.

  • Clinical Psychologist
  • Richmond Heights, MO
  • NPI 1952634347
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470009600000",
    "number": "1841743317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 OAKLAND AVE",
            "address_2": "SUITE 105",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171868",
            "telephone_number": "314-884-0779",
            "fax_number": "314-227-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 OAKLAND AVE",
            "address_2": "SUITE 105",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171868",
            "telephone_number": "314-884-0779",
            "fax_number": "314-227-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES OF ST. LOUIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "314-884-8075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2010030791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yocheved Judy Polter, FNP-BC
• Brock Pope, OTD
• John A. Powell, M.D.
• Leonard William Powers, M.S.W.
• Lukas Michael Presley, MS, LPC, NCC
• Purposeful Pathways LLC
• Marc D Radabaugh, MD
• Karen M Ramos, MSW, LMSW
• James Redmond
• Katherine Rose Reilly

• Clinical Psychologist in Richmond Heights, MO
• Providers in Richmond Heights, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.