Goodwill Industries of the Southern Piedmont Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

MHL 060 016 Issued in NC

Legal business name

GOODWILL INDUSTRIES OF THE SOUTHERN PIEDMONT INC

Practice address

2122 Freedom Dr
Charlotte, NC 28208-5154

Phone

(704) 372-3434

Fax

(704) 972-9841

NPI assigned

May 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael J Elder

Title

Chief Executive Officier

Phone

(704) 372-3434

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053528687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668768",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282668768",
            "telephone_number": "704-372-3434",
            "fax_number": "704-972-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 FREEDOM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085154",
            "telephone_number": "704-372-3434",
            "fax_number": "704-972-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL INDUSTRIES OF THE SOUTHERN PIEDMONT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICIER",
        "authorized_official_telephone_number": "704-372-3434",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "MHL 060 016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Goodman, MD
• Emily Goodrich, NP
• Katonia Howard Goods, LCSW-A
• Kathleen Bess Goodson, PA
• Alan Goodstat, LCSW
• Amanda Houston Goodwin, LCSW
• Ashley Niesha Goodwin, LCSWA
• Donna Marie Goodwin, PT
• Hailey Goodwin, LCMHCA
• Halle Rochelle Goodwin, MD

• Developmentally Disabled Services Day Training Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Developmentally Disabled Services Day Training Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.