Active NPI
Robyn Sue Goldman, ED.D
- Psychologist
- Bridgeport, CT
National Provider Identifier
1992924807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 003013
- Practice address
- 2400 Main St
Bridgeport, CT 06606-5323 - Phone
- (203) 362-3908
- Fax
- (203) 362-2463
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 000151 | CT | |
| Psychologist | 103T00000X | 003013 | CT | Primary |
Addresses
Primary practice location
2400 Main St
Bridgeport, CT 06606-5323
Mailing address
2400 Main St
Bridgeport, CT 06606-5323
Phone (203) 362-3908
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004039251 | Medicaid | CT |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003013 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288569600000",
"number": "1992924807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066065323",
"telephone_number": "203-362-3908",
"fax_number": "203-362-2463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066065323",
"telephone_number": "203-362-3908",
"fax_number": "203-362-2463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "ROBYN",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "ED.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2010-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "000151",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "003013",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004039251",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.