Provider Demographics
NPI:1205319464
Name:DR. BETH A. GOOD DNP, APRN, PMHCNS-BC, LLC
Entity type:Organization
Organization Name:DR. BETH A. GOOD DNP, APRN, PMHCNS-BC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:320-492-0329
Mailing Address - Street 1:145 2ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1602
Mailing Address - Country:US
Mailing Address - Phone:320-496-4663
Mailing Address - Fax:664-351-1288
Practice Address - Street 1:145 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1602
Practice Address - Country:US
Practice Address - Phone:320-496-4663
Practice Address - Fax:866-435-1128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty