=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144138660
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEGAN K GOLLEY PSYCHOLOGICAL SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2026
-----------------------------------------------------
Last Update Date | 08/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 N GREENBUSH ROAD STE 3 #1009
-----------------------------------------------------
City | RENSSELAER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12144-8412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-227-1995
-----------------------------------------------------
Fax | 518-760-6519
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 N GREENBUSH ROAD STE 3 #1009
-----------------------------------------------------
City | RENSSELAER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12144-8412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-227-1995
-----------------------------------------------------
Fax | 518-760-6519
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOLOGIST
-----------------------------------------------------
Name | DR. MEGAN K GOLLEY
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 518-227-1995
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------