Provider Demographics
NPI:1598814204
Name:GOODIN, DAVID (M ED)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GOODIN
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 E ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-5485
Mailing Address - Country:US
Mailing Address - Phone:426-839-2550
Mailing Address - Fax:423-839-2552
Practice Address - Street 1:1517 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-5485
Practice Address - Country:US
Practice Address - Phone:423-839-2550
Practice Address - Fax:423-839-2552
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health