Provider Demographics
NPI:1619740727
Name:GOODSON, JOANIE MICHELE
Entity Type:Individual
Prefix:MRS
First Name:JOANIE
Middle Name:MICHELE
Last Name:GOODSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANIE
Other - Middle Name:MICHELE
Other - Last Name:GOODSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1095 EAST DIXON BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152
Mailing Address - Country:US
Mailing Address - Phone:980-306-4201
Mailing Address - Fax:
Practice Address - Street 1:1895 E DIXON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6901
Practice Address - Country:US
Practice Address - Phone:980-306-4201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor