Provider Demographics
NPI:1992759401
Name:GOLIN, JORDAN LAWRENCE (PSYD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:LAWRENCE
Last Name:GOLIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5743 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1515
Mailing Address - Country:US
Mailing Address - Phone:412-422-7200
Mailing Address - Fax:412-422-9540
Practice Address - Street 1:5743 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1515
Practice Address - Country:US
Practice Address - Phone:412-422-7200
Practice Address - Fax:412-422-9540
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008704L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist