DR. MITCHELL ROBERT GOLDSTEIN (NPI# 1659335636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659335636 |
| Entity Type | Individual |
| Full Name | DR. MITCHELL ROBERT GOLDSTEIN |
| Credential | M.D. |
| Practice Address |
107 N Eddy St South Bend IN 46617-2920 |
| Practice Telephone | 5742461036 |
| Practice Fax Number | 5742461634 |
| Mailing Telephone | 5742461036 |
| Mailing Fax Number | 5742461634 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2012-06-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
01041575 | IN | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
01041575 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100346980A | 05 | |
| IN | 100346980B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770684474 | Mitchell Niles Goldstein | Orthopaedic Surgery | 325 Merrick Ave Ste 3, East Meadow, NY 11554-1556 | 2006-09-26 |
| 1922041060 | Mitchell Reid Goldstein | Pediatrics | 19115 Harnett St, Northridge, CA 91326-3009 | 2006-06-14 |
| 1770576811 | Mitchell Frank Goldstein | Optometrist | 6300 N Federal Hwy, Ft Lauderdale, FL 33308-1906 | 2005-08-24 |
| 1568468445 | Mitchell E Goldstein | Family Medicine | 9970 Central Park Blvd N Ste 400, Boca Raton, FL 33428-2236 | 2005-06-24 |
| 1659867489 | Mitchell Goldstein | Nurse Practitioner | 1600 W Avenue J, Lancaster, CA 93534-2814 | 2018-07-04 |
| 1275780090 | Mitchell Ira Goldstein | Pharmacist | 70 E 161st St, Bronx, NY 10451-2207 | 2008-08-22 |
| 1497773030 | Mitchell B Goldstein | Surgery | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2006-07-18 |
| 1710947247 | Mitchell Goldstein | Internal Medicine | 9880 Bustleton Ave, Suite 332, Philadelphia, PA 19115-2185 | 2006-03-27 |
| 1518947084 | Mitchell Goldstein | Pediatrics | 600 N Wolfe St, Johns Hopkins, Baltimore, MD 21205-2101 | 2006-01-19 |
| Street Address |
107 N EDDY ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864126 | Carrie Conder | Social Worker | 107 N Eddy St, South Bend, IN 46617-2920 | 2019-04-12 |
| 1326567496 | Rachel Mialkowski | Counselor | 107 N Eddy St, South Bend, IN 46617-2920 | 2017-09-11 |
| 1760868178 | Diana Marchunt | Social Worker | 107 N Eddy St, South Bend, IN 46617-2920 | 2015-08-07 |
| 1992116107 | Ashley S Kolbe | Social Worker | 107 N Eddy St, South Bend, IN 46617-2920 | 2014-05-12 |
| 1457793572 | Mari Chamberlin | Counselor | 107 N Eddy St, South Bend, IN 46617-2920 | 2013-07-18 |
| 1235486457 | Alba Giraldo | Counselor | 107 N Eddy St, South Bend, IN 46617-2920 | 2012-08-07 |
| 1700196698 | Mitchell R Goldstein, Md | Community/Behavioral Health | 107 N Eddy St, South Bend, IN 46617-2920 | 2010-10-14 |
| 1508185141 | Lisa B Kelly | Social Worker | 107 N Eddy St, South Bend, IN 46617-2920 | 2010-05-21 |
| 1871723338 | Kathy J Canady-nagy | Social Worker | 107 N Eddy St, South Bend, IN 46617-2920 | 2009-07-19 |
| 1053471003 | Joan Louise Pontius | Counselor | 107 N Eddy St, South Bend, IN 46617-2920 | 2006-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1023429115 | Morning View Assisted Living LLC | Assisted Living Facility | 475 N. Niles Avenue, South Bend, IN 46617 | 2014-05-12 |
| 1265861231 | Rebecca Busenbark | Physical Therapist | 401 E Colfax Ave Ste 102, South Bend, IN 46617 | 2013-11-11 |
| 1962709071 | Doreen Danice Huddleston | Social Worker | 928 East Wayne St, Suit C, South Bend, IN 46617 | 2011-02-25 |
| 1487981734 | Mary Cecilia Roemer | Marriage & Family Therapist | 616 E. Colfax Ave, South Bend, IN 46617 | 2009-11-06 |
| 1225264054 | Sridhar Meda | Dentist | 1005 East Lasalle Ave, South Bend, IN 46617 | 2009-06-08 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437366481 | Michael Reed Johns | Dentist | 103 South Eddy Street, South Bend, IN 46617 | 2007-05-17 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| Find all providers in zip 46617 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508046624 | Kearn D Hinchman D O Inc | Psychiatry & Neurology | 53779 Generations Dr Ste 1, South Bend, IN 46635-1576 | 2007-11-06 |
| 1629376645 | Beacon Medical Group, Inc. | Psychiatry & Neurology | 707 N Michigan St Ste 400, South Bend, IN 46601-1071 | 2011-03-01 |
| 1184714917 | Kristin N Smith | Psychiatry & Neurology | 403 E Madison St, South Bend, IN 46617-2322 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659695278 | Harmony Medical Associates LLC | Psychiatry & Neurology | 11837 Wedgeport Ln, Fishers, IN 46037-7987 | 2010-03-25 |
| 1144337791 | Benjamin Louis Troy | Psychiatry & Neurology | 230 East Day Road, Suite 160, Mishawaka, IN 46545-3463 | 2006-08-23 |
| 1770526618 | Elizabeth A Taylor | Psychiatry & Neurology | 3055 N Lake Ct, Newburgh, IN 47630 | 2006-06-14 |
| 1407807746 | Syed J Khan | Psychiatry & Neurology | 10765 Lantern Road, Suite 102, Fishers, IN 46038-3597 | 2006-05-12 |
| 1821060294 | Michael Welling | Psychiatry & Neurology | 2040 Shadeland Ave, Ste 200, Indianapolis, IN 46219-1734 | 2006-02-01 |
| 1184616294 | Fadia T Aldahan | Psychiatry & Neurology | 5502 East 16th Street, Suite A21, Indianapolis, IN 46218-4932 | 2005-08-16 |
| 1700337920 | Kledzik Psychiatric LLC | Psychiatry & Neurology | 9245 N Meridian St, 225, Indianapolis, IN 46260-1836 | 2016-10-24 |
| 1255714390 | Ahmed Montaser | Psychiatry & Neurology | 121 Buntin St, Vincennes, IN 47591-1320 | 2015-07-07 |
| 1215334008 | Mind Md LLC | Psychiatry & Neurology | 833 Park East Blvd, Lafayette, IN 47905-0785 | 2014-11-24 |
| 1326458514 | Ambreen Khan Ghori | Psychiatry & Neurology | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2014-04-28 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.