Provider Demographics
NPI:1831228055
Name:GOOD, MARVIN L (BSW)
Entity type:Individual
Prefix:MR
First Name:MARVIN
Middle Name:L
Last Name:GOOD
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-2816
Mailing Address - Country:US
Mailing Address - Phone:989-990-1471
Mailing Address - Fax:
Practice Address - Street 1:1321 S FAYETTE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-1447
Practice Address - Country:US
Practice Address - Phone:989-792-8000
Practice Address - Fax:989-792-8445
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)