Provider Demographics
NPI:1982674131
Name:GOODMAN, ROBERT C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 TINSLEY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1531
Mailing Address - Country:US
Mailing Address - Phone:336-841-4307
Mailing Address - Fax:336-841-7267
Practice Address - Street 1:3929 TINSLEY DR STE 104
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1531
Practice Address - Country:US
Practice Address - Phone:336-841-4307
Practice Address - Fax:336-841-7267
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0034391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9406475OtherPHCS
NC7874312OtherAETNA
NC135NHOtherBCBS
NC2048291OtherCIGNA
NC277767000OtherMAGELLAN
NCD7673OtherMEDCOST
NC9406475OtherPHCS
NC6106136Medicaid