Provider Demographics
NPI:1639243728
Name:GOLDSTEIN, HAROLD (PHD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12008 BOGAN CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2869
Mailing Address - Country:US
Mailing Address - Phone:301-588-8176
Mailing Address - Fax:301-340-9210
Practice Address - Street 1:12008 BOGAN CT
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2869
Practice Address - Country:US
Practice Address - Phone:301-588-8176
Practice Address - Fax:301-340-9210
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD430103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist