| Keith Golin Phd | |
|
659 Eagle Rock Ave Ste 4 West Orange NJ 07052-2138 | |
| (888) 284-2034 | |
| (973) 992-4639 |
| Full Name | Keith Golin Phd |
|---|---|
| Speciality | Psychologist |
| Location | 659 Eagle Rock Ave Ste 4, West Orange, New Jersey |
| Authorized Official Name and Position | Keith Golin (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9739924639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Golin Phd 18 Aspen Dr Livingston NJ 07039-1432 Ph: (888) 284-2034 | Keith Golin Phd 659 Eagle Rock Ave Ste 4 West Orange NJ 07052-2138 Ph: (888) 284-2034 |
| NPI Number | 1487660213 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 05/24/2021 |
| Certification Date | 04/29/2021 |
| Medicare PECOS PAC ID | 6608879226 |
|---|---|
| Medicare Enrollment ID | O20070227000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487660213 | NPI | - | NPPES |
| 0114065 | Medicaid | NJ | |
| 02330954 | Medicaid | NY | |
| 6102096 | Other | NJ | EVERCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 35S100409900 (New Jersey) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Patricia A Delgaldo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124188800 PECOS PAC ID: 8527953702 Enrollment ID: I20040217000594 |
| Provider Name | John L Weagley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467426601 PECOS PAC ID: 3274571427 Enrollment ID: I20050419001180 |
| Provider Name | Barbara Ellen Fox |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366518953 PECOS PAC ID: 3072554039 Enrollment ID: I20050519000652 |
| Provider Name | Keith Golin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689610875 PECOS PAC ID: 2567479132 Enrollment ID: I20060308000006 |
| Provider Name | Carl W Ziesing |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366572174 PECOS PAC ID: 9335248236 Enrollment ID: I20070618000391 |
| Provider Name | Dara S Rosenbaum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952535841 PECOS PAC ID: 6002961703 Enrollment ID: I20090902000038 |
| Provider Name | Gay Eisenhardt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558385765 PECOS PAC ID: 4789863465 Enrollment ID: I20110127000126 |
| Provider Name | Traci M Zuckerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306110705 PECOS PAC ID: 3375704950 Enrollment ID: I20120406000273 |
| Provider Name | Christine Truhe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477763571 PECOS PAC ID: 6709979255 Enrollment ID: I20140404000036 |
| Provider Name | Lori A Katzman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851705461 PECOS PAC ID: 0941427579 Enrollment ID: I20140805002598 |
| Provider Name | Seema S Shah |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811432545 PECOS PAC ID: 3476836248 Enrollment ID: I20170202000820 |
| Provider Name | Stanley E Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831208644 PECOS PAC ID: 2062314610 Enrollment ID: I20170525000664 |
| Provider Name | Amy Knitzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023536406 PECOS PAC ID: 9638445489 Enrollment ID: I20171023000617 |
| Provider Name | Juliet K Procopio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104257054 PECOS PAC ID: 7214369099 Enrollment ID: I20191115002478 |
| Provider Name | Angela W Leone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801422886 PECOS PAC ID: 0345679619 Enrollment ID: I20200408000321 |
| Provider Name | Joyce Y Tiemens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710522115 PECOS PAC ID: 0446680573 Enrollment ID: I20200414000007 |
| Provider Name | Nicholas Repice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104291038 PECOS PAC ID: 4385067701 Enrollment ID: I20200701003088 |
| Provider Name | Eunice Won Joo Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942744867 PECOS PAC ID: 3274952239 Enrollment ID: I20200925000043 |
| Provider Name | Patricia Taveras |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700473964 PECOS PAC ID: 4789097452 Enrollment ID: I20210119002949 |
| Provider Name | Suzanne Haber Berman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467964296 PECOS PAC ID: 8224437157 Enrollment ID: I20210526002236 |
| Provider Name | Christy Hudak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942798434 PECOS PAC ID: 0648670802 Enrollment ID: I20210610001157 |
| Provider Name | Ellen L Koehler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659941391 PECOS PAC ID: 2163826728 Enrollment ID: I20210804003420 |
| Provider Name | Sonia Illescas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710638655 PECOS PAC ID: 0446642672 Enrollment ID: I20220121000370 |
| Provider Name | Caroline K Hartshorne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003218678 PECOS PAC ID: 7719370071 Enrollment ID: I20220209000326 |
| Provider Name | Tule Anita Chau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225743594 PECOS PAC ID: 6305218041 Enrollment ID: I20230207001129 |
| Provider Name | Sherrill Welcome |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457068264 PECOS PAC ID: 6002280302 Enrollment ID: I20230329000522 |
| Provider Name | Kathleen Shelley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023659331 PECOS PAC ID: 5496113946 Enrollment ID: I20230615002032 |
| Provider Name | Lindsey Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053667576 PECOS PAC ID: 2163883729 Enrollment ID: I20230728001069 |
| Provider Name | Krystal Lynn Moir |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386323947 PECOS PAC ID: 8022471051 Enrollment ID: I20230824000046 |
| Provider Name | Talisah Ida Mae Harrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477048478 PECOS PAC ID: 3476917915 Enrollment ID: I20230915002792 |
| Provider Name | Gianna Novelli |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760548838 PECOS PAC ID: 3072588367 Enrollment ID: I20240304003150 |
| Provider Name | Najamah Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437715828 PECOS PAC ID: 3577005768 Enrollment ID: I20240603003468 |
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