Patricia Rogers Goodyear, PH.D

Individual provider Active NPI Psychologist · Greenville, SC

NPI 1356853535 · NPPES record last updated Oct 28, 2017

Key facts

NPI
1356853535
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
529 (SC)
Practice address
117 W Antrim Dr
Greenville, SC 29607-2505
Phone
(864) 313-5669
NPI assigned
Oct 28, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
529SCMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 529 SC Yes

Addresses

Primary practice location

117 W Antrim Dr
Greenville, SC 29607-2505

Mailing address

117 W Antrim Dr
Greenville, SC 29607-2505
Phone (864) 313-5669

Other providers in Greenville, SC

All providers in Greenville, SC · Psychologist in South Carolina

Sources for this page

Verify at the official NPI Registry.