Provider Demographics
NPI:1083315857
Name:GOODE, ANTHONY CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHRISTOPHER
Last Name:GOODE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WHITMAN
Mailing Address - State:MA
Mailing Address - Zip Code:02382-1340
Mailing Address - Country:US
Mailing Address - Phone:774-251-4550
Mailing Address - Fax:
Practice Address - Street 1:946 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1340
Practice Address - Country:US
Practice Address - Phone:774-251-4550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty