MITCHELL R GOLDSTEIN, MD (NPI# 1700196698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700196698 |
| Entity Type | Organization |
| Organization Name | MITCHELL R GOLDSTEIN, MD |
| Practice Address |
107 N Eddy St South Bend IN 46617-2920 |
| Practice Telephone | 5745320153 |
| Practice Fax Number | 5742461634 |
| Mailing Telephone | 5745320153 |
| Mailing Fax Number | 5742461634 |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-18 |
| Authorized Official Name | DR. MITCHELL ROBERT GOLDSTEIN (OWNER) |
| Authorized Official Telephone | 5745320153 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100346980B | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MITCHELL R GOLDSTEIN, MD LLC | 107 N Eddy St, South Bend, IN 46617 |
| Indiana Business Entities | MITCHELL R GOLDSTEIN, MD PROPERTIES LLC | 107 N Eddy Street, South Bend, IN 46617 |
| Street Address |
107 N EDDY ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659335636 | Mitchell Robert Goldstein | Psychiatry & Neurology | 107 N Eddy St, South Bend, IN 46617-2920 | 2006-04-14 |
| 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 |
| 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 | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497398762 | Kylie Rogalla | Counselor | 22355 Applewood Ln, South Bend, IN 46628-9708 | 2019-10-19 |
| 1588815260 | Denise Annette Sellers | Counselor | 432 S Lafayette Blvd, South Bend, IN 46601-2204 | 2008-10-01 |
| 1841748449 | Melissa Buddie | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2016-09-13 |
| 1235486457 | Alba Giraldo | Counselor | 107 N Eddy St, South Bend, IN 46617-2920 | 2012-08-07 |
| 1861721136 | Samaritan Family Health and Counseling Center, Inc. | Counselor | 17195 Cleveland Rd, South Bend, IN 46635-1415 | 2009-12-16 |
| 1710164603 | Megan Greulich | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2008-01-23 |
| 1679783187 | Sharon Marie Burden | Counselor | 818 E Jefferson Blvd, South Bend, IN 46617-2905 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049926 | Lindsay Blair Charles | Counselor | 100 Saw Mill Rd Ste 3300, Lafayette, IN 47905-5598 | 2020-10-07 |
| 1063024347 | Kimberly Nolan | Counselor | 1236 Monteray Cir, Lawrenceburg, IN 47025-9213 | 2020-08-19 |
| 1477171429 | Karissa Fails Rumsey | Counselor | 11109 Lexi Ln, Fishers, IN 46040-9117 | 2020-07-07 |
| 1255960795 | Ramzi Y. Skaik | Counselor | 303 E Court Ave Ste 434, Jeffersonville, IN 47130-9998 | 2020-04-06 |
| 1649808163 | Nicole Bebiak | Counselor | 7595 Royal Fern Ln, Noblesville, IN 46062-6617 | 2020-03-30 |
| 1023669868 | Karen Fischer | Counselor | 5031 Knollfield Pl, Fort Wayne, IN 46809-9521 | 2019-09-23 |
| 1639729353 | Joel Harris | Counselor | 351 Monroe St, Huntington, IN 46750-3262 | 2019-09-14 |
| 1396395356 | Marla L Godette | Counselor | 11959 Adams Rd, Granger, IN 46530-7519 | 2019-09-12 |
| 1477116986 | Angela M Fisher | Counselor | 5109 N College Ave, Indianapolis, IN 46205-1135 | 2019-04-19 |
| 1982171872 | Julie Wennekes | Counselor | 12 E Ripplewater Ave, Beverly Shores, IN 46301-0249 | 2018-10-29 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
Please comment or provide details below to improve the information on MITCHELL R GOLDSTEIN, MD.
| 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.