Evan Malcolm Goodfellow

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1010 N Hancock St
Philadelphia, PA 19123-2334

Phone

(267) 807-0550

NPI assigned

Jul 25, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Elevated Kids

  • Behavior Analyst
  • Philadelphia, PA
  • NPI 1871128850

  Behavior Technician

  NPD

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1245911130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 S 20TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N HANCOCK ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191232334",
            "telephone_number": "267-807-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODFELLOW",
        "first_name": "EVAN",
        "middle_name": "MALCOLM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Goodbody, M.D.
• Dana F Goode, PSY D
• Natalie Goode, PHARMD, BCACP
• Chanell-Nicole Gooden, MFT
• Elliot Goodenough, MD, PHD
• Goodheart Pharmacy
• Goodheart Pharmacy Inc
• Nichola Goodin, PA-C
• Anita Reinette Gooding, LSW
• Anne Goodman

• Behavior Technician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Behavior Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.