Active NPI
Therese Georgette Goodchild, M.S., CCC-SLP, M.E.D
- Speech-Language Pathologist
- Worcester, MA
National Provider Identifier
1194029512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 0003655
- Practice address
- 37 Brantwood Rd
Worcester, MA 01602-1705 - Phone
- (413) 695-6670
- NPI assigned
- Dec 28, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 0003655 | MA | Primary |
Addresses
Primary practice location
37 Brantwood Rd
Worcester, MA 01602-1705
Mailing address
37 Brantwood Rd
Worcester, MA 01602-1705
Phone (413) 695-6670
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0304336 | Medicaid | MA | |
| 0003655 | Other | MA | LICENSE # |
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)
- Not enrolled
- Credentials
- Master of Education, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0003655 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293494400000",
"number": "1194029512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 BRANTWOOD RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016021705",
"telephone_number": "413-695-6670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 BRANTWOOD RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016021705",
"telephone_number": "413-695-6670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODCHILD",
"first_name": "THERESE",
"middle_name": "GEORGETTE",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP, M.E.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-28",
"last_updated": "2010-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "0003655",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0304336",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "0003655",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.