Provider Demographics
NPI:1689695975
Name:GOEKE, JOHN MORRIS (PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MORRIS
Last Name:GOEKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 QUAKER LN
Mailing Address - Street 2:SUITE 207 C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:
Practice Address - Street 1:606 N ELM ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4332
Practice Address - Country:US
Practice Address - Phone:336-889-8877
Practice Address - Fax:336-889-3488
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1813103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
198456OtherMEDCOST
42339OtherPARTNERS
159642OtherUNITED BEHAVORIAL HEALTH
0341HOtherBCBS
NC6000824Medicaid
5714410OtherAETNA
NC6005881Medicaid
42339OtherPARTNERS
5714410OtherAETNA