Provider Demographics
NPI:1033148366
Name:GOODSTONE, ERICA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:M
Last Name:GOODSTONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1493
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33443-1493
Mailing Address - Country:US
Mailing Address - Phone:954-649-5228
Mailing Address - Fax:
Practice Address - Street 1:1228 HILLSBORO MILE
Practice Address - Street 2:APT 105
Practice Address - City:HILLSBORO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1341
Practice Address - Country:US
Practice Address - Phone:954-649-5228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA008892225700000X
FLMH0001738101YM0800X
NJ37FI01231106H00000X
NY004187225700000X
CT001649101YP2500X
CT001505225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist