Shelby Gooden

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-51429 Issued in TX

Practice address

7440 Highway 92
Woodstock, GA 30189-5235

Phone

(770) 212-2170

NPI assigned

Dec 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Moon River, LLC

  • Behavior Analyst
  • Marietta, GA
  • NPI 1730143553
  NPD
• Behavioral Transformations, LLC

  • Behavior Analyst
  • Garland, TX
  • NPI 1316336043
  NPD (past)

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1104412840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N GOLIAD ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750872230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7440 HIGHWAY 92",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895235",
            "telephone_number": "770-212-2170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3470 Florence Rd",
            "address_purpose": "LOCATION",
            "city": "Powder Springs",
            "state": "GA",
            "postal_code": "301276026",
            "country_code": "US",
            "telephone_number": "770-212-2170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODEN",
        "first_name": "SHELBY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2023-12-12",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-18-70655",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-21-51429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valeria Gonzalez Camacho
• Victor Gonzalez Jr., PSY.D.
• Wilayneth Del Carmen Gonzalez, MD
• Tyler D Good
• Allison Goode
• Adele Handy Goodloe, M.D.
• Katrina Marie Goodman
• Mandy Goodwin, LCSW
• Teena Gopalakrishna, MA, BCBA, LBA
• Rachael Brooke-Ann Gordon-Tupman, MSN, APRN, FNP-BC

• Behavior Analyst in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.