Active NPI
Stephanie Goodson, MS, LPA
- Psychologist
- Waxhaw, NC
National Provider Identifier
1538778584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2223
- Practice address
- 1638 Lookout Cir
Waxhaw, NC 28173-8085 - Phone
- (704) 576-5216
- NPI assigned
- Jul 27, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2223 | NC | Primary |
Addresses
Primary practice location
1638 Lookout Cir
Waxhaw, NC 28173-8085
Mailing address
204 Red Twig CT
Marvin, NC 28173-6826
Phone (704) 576-5216
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2223 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clear Foundations Therapy and Assessment PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Charlotte, NC
- NPI 1083395339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1538778584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 RED TWIG CT",
"city": "MARVIN",
"state": "NC",
"postal_code": "281736826",
"telephone_number": "704-576-5216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1638 LOOKOUT CIR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281738085",
"telephone_number": "704-576-5216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSON",
"first_name": "STEPHANIE",
"credential": "MS, LPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-27",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "2223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.