Provider Demographics
NPI:1205599354
Name:GOLDBERG, LINDSEY RENEE (PMHNP)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:RENEE
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 PIEDMONT ROW DR S STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28287-3803
Mailing Address - Country:US
Mailing Address - Phone:910-209-3396
Mailing Address - Fax:
Practice Address - Street 1:6060 PIEDMONT ROW DR S STE 500
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28287-3803
Practice Address - Country:US
Practice Address - Phone:855-501-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228097163W00000X
NC5016202363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1205599354Medicaid