| Edward Goldenberg, Md Psc Pc | |
|
930 Redgate Ave Norfolk VA 23507-1518 | |
| (757) 626-3733 | |
| (757) 626-3331 |
| Full Name | Edward Goldenberg, Md Psc Pc |
|---|---|
| Speciality | Psychologist |
| Location | 930 Redgate Ave, Norfolk, Virginia |
| Authorized Official Name and Position | Edward Goldenberg (DIRECTOR) |
| Authorized Official Contact | 7576263733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Goldenberg, Md Psc Pc 930 Redgate Avenue Norfolk VA 23507 Ph: (757) 626-3733 | Edward Goldenberg, Md Psc Pc 930 Redgate Ave Norfolk VA 23507-1518 Ph: (757) 626-3733 |
| NPI Number | 1619081742 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 01/09/2008 |
| Medicare PECOS PAC ID | 6406804723 |
|---|---|
| Medicare Enrollment ID | O20050104000367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619081742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | 0101046618 (Virginia) | Primary |
| Provider Name | Edward Goldenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396818191 PECOS PAC ID: 9234328501 Enrollment ID: I20110118001136 |
| Provider Name | Therese Chana Lantz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598004517 PECOS PAC ID: 6406085463 Enrollment ID: I20140215000201 |
| Provider Name | Jodi Baker Hutchinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407394497 PECOS PAC ID: 8729365028 Enrollment ID: I20170515000067 |
| Provider Name | Carol Joyce Wesley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124530837 PECOS PAC ID: 7113286857 Enrollment ID: I20180125001681 |
| Provider Name | Marcella R Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003329020 PECOS PAC ID: 6204196207 Enrollment ID: I20180213001723 |
| Provider Name | Bridget Peery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619322930 PECOS PAC ID: 7113254459 Enrollment ID: I20190809001168 |
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