Provider Demographics
NPI:1760722466
Name:GOODYEAR, SARA IRENE JOHNSTON (MSED, NCC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:IRENE JOHNSTON
Last Name:GOODYEAR
Suffix:
Gender:F
Credentials:MSED, NCC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:IRENE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED, LPC, NCC
Mailing Address - Street 1:100 N BELLEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2600
Mailing Address - Country:US
Mailing Address - Phone:412-246-5624
Mailing Address - Fax:412-246-5610
Practice Address - Street 1:100 N BELLEFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2600
Practice Address - Country:US
Practice Address - Phone:412-264-5624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool