Goldberg, Richard Thayer

Goldberg, Richard Thayer is an individual health care provider with primary practice located at 125 Nashua St , Boston MA 02114-1198. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Goldberg, Richard Thayer can be contacted via phone (617) 573-2608.

Contact Information

Primary practice address
125 Nashua St Boston MA 02114-1198
Phone: (617) 573-2608
Fax: (617) 573-7119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1344 Massachusetts

Profile Details

NPI number 1326039512
LBN Legal business name Goldberg, Richard Thayer
Credentials EDD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326039512 NPPES
Massachusetts Other W02464 BCBS MA
Massachusetts MEDICAID 0520004 BCBS MA

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