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Contact Information

MICHAEL W GOLDBERG, M.A.
113 HAWK DRIVE
DULCE, NM87528
 Phone: 505-759-2954
 Fax: 505-759-1349
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

School

103TS0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MICHAEL W GOLDBERG · (Male)

NPI Number 1043340987
Status Active
Credentials M.A.
Entity Individual
Enumeration date 03/07/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • NM License # 308194
  • NM Medicaid 27087859
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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