Jerald M Gottlieb, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002692 Issued in GA

Practice address

7 Oglethorpe Professional Blvd
Unit 3
Savannah, GA 31406-3608

Phone

(912) 224-5841

Fax

(912) 352-4220

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jerald M. Gottlieb, PH.D, P.C.

  • Clinical Psychologist
  • Savannah, GA
  • NPI 1275866527
  NPD Authorized official
• North Dallas Psychological Practice

  • Clinical Psychologist
  • Dallas, TX
  • NPI 1538256771
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1972548907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 OGLETHORPE PROFESSIONAL BLVD",
            "address_2": "UNIT 3",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063608",
            "telephone_number": "912-224-5841",
            "fax_number": "912-352-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 OGLETHORPE PROFESSIONAL BLVD",
            "address_2": "UNIT 3",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063608",
            "telephone_number": "912-224-5841",
            "fax_number": "912-352-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "JERALD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "663871593A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Victoriayevgeniyevna Gorokhova
• Katherine Gosden, FNP
• Latroya Goslee, RBT
• Jamie Bridges Goss, SURGICAL FIRST ASSIS
• Dvora Gottlieb, MMS, CCC
• John Conrad Gouse, M.D.
• Deepak Goyal, MD
• William Michael Grabowski, PA-C
• Grace Autism Services Inc
• Angela Grace, M.S. CCC-SLP

• Clinical Psychologist in Savannah, GA
• Providers in Savannah, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.