Healthcare Provider Details

I. General information

NPI: 1639243728
Provider Name (Legal Business Name): HAROLD GOLDSTEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12008 BOGAN CT
POTOMAC MD
20854-2869
US

IV. Provider business mailing address

12008 BOGAN CT
POTOMAC MD
20854-2869
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-8176
  • Fax: 301-340-9210
Mailing address:
  • Phone: 301-588-8176
  • Fax: 301-340-9210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number430
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number430
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: