Goldstein, Clark R.

Goldstein, Clark R. is an sole proprietor health care provider with primary practice located at 1981 Marcus Avenue Suite C-102 Nyu Child Study Center, Lake Success NY 11042. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Goldstein, Clark R. can be contacted via phone (516) 358-1808.

Contact Information

Primary practice address
1981 Marcus Avenue Suite C-102 Nyu Child Study Center Lake Success NY 11042
Phone: (516) 358-1808
Fax: (646) 754-9854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Psychologist 103T00000X 019503 New York
Behavioral Health & Social Service Providers / Psychologist 103T00000X 50019503 New York

Profile Details

NPI number 1215121710
LBN Legal business name Goldstein, Clark R.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2007
Last updated Apr 7th, 2016 - about 8 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 1215121710 NPPES
Massachusetts Other M18708 BLUE CROSS
Massachusetts MEDICAID 1312677 BLUE CROSS

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