MEDICARE: KEITH GOLIN PHD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist
2	103TC0700X	Clinical Psychologist	35S100409900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	6102096	OTHER	NJ	EVERCARE

General Provider Information

NPI Number	:	1487660213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEITH GOLIN PHD LLC

Provider Business Mailing Address
First Line	:	18 ASPEN DR
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-1432
Country	:	US
Telephone Number	:	888-284-2034
Fax Number	:	973-992-4639

Provider Business Practice Location Address
First Line	:	659 EAGLE ROCK AVE STE 4
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2138
Country	:	US
Telephone Number	:	888-284-2034
Fax Number	:	973-992-4639

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. KEITH GOLIN
Credential	:	PHD
Telephone Number	:	973-992-4639

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	05/24/2021

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1689610875 — KEITH GOLIN PH.D.
Practice Location Address:

659 EAGLE ROCK AVE , STE 4
WEST ORANGE, NJ
07052-2138

Practice Phone: 888-284-2034
Practice Fax: 973-992-4639

1831228584 — CLEA WEISS
Practice Location Address:

659 EAGLE ROCK AVE
WEST ORANGE, NJ
07052-2138

Practice Phone: 973-895-2102
Practice Fax:

1366572174 — CARL W ZIESING PHD
Practice Location Address:

659 EAGLE ROCK AVE , SUITE 4
WEST ORANGE, NJ
07052-2138

Practice Phone: 201-321-0347
Practice Fax: 302-422-8697

1447554688 — DIVINE TOUCH HEALTHCARE SERVICES LLC
Practice Location Address:

659 EAGLE ROCK AVE , SUITE 20
WEST ORANGE, NJ
07052-2138

Practice Phone: 973-517-4191
Practice Fax:

Directions to “KEITH GOLIN PHD LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.