Individual provider Active NPI

Jennifer Lynn Goldin, PH.D.

  • Clinical Psychologist
  • Cooper City, FL
National Provider Identifier
1881795193
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 6680 Issued in FL
Practice address
13160 Parkside Ter
Cooper City, FL 33330-2641
Phone
(954) 680-7725
NPI assigned
Sep 26, 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 PY 6680 FL Primary

Addresses

Primary practice location

13160 Parkside Ter
Cooper City, FL 33330-2641

Mailing address

13160 Parkside Ter
Cooper City, FL 33330-2641
Phone (954) 680-7725

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
PY 6680FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881795193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13160 PARKSIDE TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333302641",
            "telephone_number": "954-680-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 PARKSIDE TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333302641",
            "telephone_number": "954-680-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDIN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.