Provider Demographics
NPI:1669561510
Name:ROBERT J. GOLDSWORTHY, PH.D., P.C.
Entity type:Organization
Organization Name:ROBERT J. GOLDSWORTHY, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOLDSWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-922-5440
Mailing Address - Street 1:SCOTTSDALE PSYCHOLOGICAL ASSOCIATES
Mailing Address - Street 2:11000 N. SCOTTSDALE RD., STE 163
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:480-922-5440
Mailing Address - Fax:480-922-5445
Practice Address - Street 1:SCOTTSDALE PSYCHOLOGICAL ASSOCIATES
Practice Address - Street 2:11000 N. SCOTTSDALE RD., STE 163
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254
Practice Address - Country:US
Practice Address - Phone:480-922-5440
Practice Address - Fax:480-922-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ908103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPHD908BMedicare ID - Type UnspecifiedMEDICARE #