Healthcare Provider Details

I. General information

NPI: 1164888509
Provider Name (Legal Business Name): DANIEL GOLDSTEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2016
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 21ST AVE S STE 306
NASHVILLE TN
37212-4929
US

IV. Provider business mailing address

2200 21ST AVE S STE 306
NASHVILLE TN
37212-4929
US

V. Phone/Fax

Practice location:
  • Phone: 615-582-2882
  • Fax:
Mailing address:
  • Phone: 615-582-2882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3318
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number3318
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3318
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number3318
License Number StateTN
# 5
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number3318
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: