Active NPI
Dan Bernard Goodkind, PH.D.
- Clinical Psychologist
- Vernal, UT
National Provider Identifier
1053418053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 359902-2501
- Practice address
- 38 E 100 N
Vernal, UT 84078-2122 - Phone
- (435) 781-8000
- Fax
- (435) 781-8001
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 359902-2501 | UT | Primary |
Addresses
Primary practice location
38 E 100 N
Vernal, UT 84078-2122
Mailing address
38 E 100 N
Vernal, UT 84078-2122
Phone (435) 781-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 359902-2501 | UT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeff Henderson PHD Psychological Services and Consulting PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053418053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 E 100 N",
"city": "VERNAL",
"state": "UT",
"postal_code": "840782122",
"telephone_number": "435-781-8000",
"fax_number": "435-781-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 E 100 N",
"city": "VERNAL",
"state": "UT",
"postal_code": "840782122",
"telephone_number": "435-781-8000",
"fax_number": "435-781-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODKIND",
"first_name": "DAN",
"middle_name": "BERNARD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "359902-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernal, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.