Goodman, David Wayne

Goodman, David Wayne is an sole proprietor health care provider with primary practice located at 2639 Sunset Avenue Suite B, Rocky Mount NC 27804-3700. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Goodman, David Wayne can be contacted via phone (252) 937-4455.

Contact Information

Primary practice address
2639 Sunset Avenue Suite B Rocky Mount NC 27804-3700
Phone: (252) 937-4455
Fax: (252) 937-3060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 0852 North Carolina
Behavioral Health & Social Service Providers / Counseling 103TC1900X 072002957 Illinois

Profile Details

NPI number 1982639803
LBN Legal business name Goodman, David Wayne
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2006
Last updated Aug 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982639803 NPPES
North Carolina Other 03624 BCBSNC
North Carolina MEDICAID 6000021 BCBSNC

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