DR. MATTHEW ETHAN GOLDENBERG PSY D
NPI 1417106675
Psychologist in Tumwater, WA

Active since September 12, 2008PECOS Enrolled
111 TUMWATER BLVD SE, SUITE 210, TUMWATER, WA 98501(206) 395-9193(360) 464-2720 Get Directions Write a Review

NPPES record last updated: August 19, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 19, 2021, Jul 13, 2018, Sep 15, 2016 (3 updates tracked since 2016).

About Dr. Matthew Ethan Goldenberg Psy D NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MATTHEW ETHAN GOLDENBERG PSY D (NPI 1417106675) is an individual psychologist in Tumwater, Washington, licensed in Washington (PY60416098) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417106675
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. MATTHEW ETHAN GOLDENBERGCredential: PSY D
Location Address111 TUMWATER BLVD SE, SUITE 210Tumwater, WA 98501
Mailing Address111 Tumwater Blvd Se, Suite 210Tumwater, WA 98501 · (206) 395-9193 · Fax (360) 464-2720
Fax(360) 464-2720
Sole ProprietorYes
Enumeration DateSeptember 12, 2008
Last NPPES UpdateAugust 19, 20213 updates tracked since enumeration
NPPES CertifiedAugust 19, 2021
NPI 1417106675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in WA · PY60416098 Licensed in WA · LH6039598
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
111 TUMWATER BLVD SE, Tumwater, WA 98501

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Matthew Ethan Goldenberg Psy D is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
111 TUMWATER BLVD SE
OLYMPIA, WA 98501
Counselor (Mental Health)
111 TUMWATER BLVD SE
TUMWATER, WA 98501
Physical Therapist
111 TUMWATER BLVD SE, SUITE 113
TUMWATER, WA 98501
Massage Therapist
111 TUMWATER BLVD SE, B106
TUMWATER, WA 98501
Dentist
111 TUMWATER BLVD SE, SUITE A300
TUMWATER, WA 98501

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Goldenberg's NPI number?

The NPI number for Matthew Goldenberg is 1417106675. It was assigned to this individual provider in the NPPES registry on September 12, 2008.

Where is Matthew Goldenberg located?

Matthew Goldenberg practices at 111 Tumwater Blvd SE Suite 210, Tumwater, WA 98501. The listed phone number is (206) 395-9193.

What is Matthew Goldenberg's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Matthew Goldenberg enrolled in Medicare?

Yes. Matthew Goldenberg is registered in the Medicare PECOS enrollment system.

What insurance does Matthew Goldenberg accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Matthew Goldenberg as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Goldenberg was last updated on August 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.