Provider Demographics
NPI:1659342988
Name:THE CENTER FOR EMOTIONAL HEALING P.C.
Entity Type:Organization
Organization Name:THE CENTER FOR EMOTIONAL HEALING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:336-841-4307
Mailing Address - Street 1:25 W GUILFORD ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-3945
Mailing Address - Country:US
Mailing Address - Phone:336-476-4880
Mailing Address - Fax:336-841-7267
Practice Address - Street 1:25 W GUILFORD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-3945
Practice Address - Country:US
Practice Address - Phone:336-476-4880
Practice Address - Fax:336-841-7267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3894101YP2500X
NCC0034391041C0700X
NCC0031481041C0700X
NCC0024261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005697Medicaid
NC6005697Medicaid