Provider Demographics
NPI:1790172138
Name:GOODE, RASHIDA
Entity Type:Individual
Prefix:
First Name:RASHIDA
Middle Name:
Last Name:GOODE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 REGISTER ST BLDG 27
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-2421
Mailing Address - Country:US
Mailing Address - Phone:786-295-2353
Mailing Address - Fax:
Practice Address - Street 1:1050 REGISTER ST BLDG 27
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-2421
Practice Address - Country:US
Practice Address - Phone:786-295-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00016251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical