Healthcare Provider Details

I. General information

NPI: 1821771106
Provider Name (Legal Business Name): CHLOE MICHELLE GOLDBACH PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 UNION ST NE FL 7
WASHINGTON DC
20002-7042
US

IV. Provider business mailing address

164 SULGRAVE CT
STERLING VA
20165-6410
US

V. Phone/Fax

Practice location:
  • Phone: 202-743-4149
  • Fax:
Mailing address:
  • Phone: 904-343-0388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number07439
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number0810008459
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY200001750
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: