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Lisa D Goldberg, PHD
Student in an Organized Health Care Education/Training Program in Scott Afb, Illinois
NPI 1073971156

Lisa D Goldberg is a Student in an Organized Health Care Education/Training Program based in Scott Afb, IL. Lisa D Goldberg practices in Scott Afb, IL and has the professional credentials of PHD. The NPI Number for Lisa D Goldberg is 1073971156 and holds a License No. 0810006275 (Illinois).

The current practice location address for Lisa D Goldberg is 310 W Losey St, Scott Afb, IL and can be reached out via phone at 618-256-7386.

Location: 310 W Losey St, Scott Afb, IL, 62225-5250
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073971156
Provider Name
Lisa D Goldberg
Credential
PHD
Provider Entity Type
Individual
Gender
Female
Address
310 W Losey St, Scott Afb, IL, 62225-5250
Phone Number
618-256-7386
Fax Number
Provider Enumeration Date
02/04/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
310 W Losey St
City
Scott Afb
State
Illinois
Zip
62225-5250
Phone Number
618-256-7386
Fax Number
person
Provider Business Mailing Address Details
Address
310 W Losey St
City
Scott Afb
State
Illinois
Zip
62225-5250
Phone Number
618-256-7386
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
()
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
0810006275 (Virginia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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