Goodwill Industries of Delaware & Delaware County Inc

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

Legal business name

GOODWILL INDUSTRIES OF DELAWARE & DELAWARE COUNTY INC

Practice address

300 E Lea Blvd
Wilmington, DE 19802-2354

Phone

(302) 761-4640

NPI assigned

Dec 15, 2020

Organization subpart

No

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

Authorized official

Name

Patricia L Brosious

Title

Workforce Initiatives Manager

Phone

(302) 504-5737

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1053907964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E LEA BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198022354",
            "telephone_number": "302-504-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E LEA BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198022354",
            "telephone_number": "302-761-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL INDUSTRIES OF DELAWARE & DELAWARE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "BROSIOUS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "WORKFORCE INITIATIVES MANAGER",
        "authorized_official_telephone_number": "302-504-5737"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000496",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221000496",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garrett Goodling, DDS
• Peter Robert Goodman, L.C.S.W., B.C.D.
• Ronald M. Goodman, D.O.
• Michele Goodson, CRNP
• Camille A. Goodspeed, DO
• James L Goodwill III, DDS
• Steven Thomas Goodwin, DPT
• Inga Nykole Goodwine
• Goodyear Medical Supplies
• Edris Goolsby Harrell, PH.D.

• Rehabilitation Psychologist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Rehabilitation Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.