Active NPI
David Matthew Good, BA
- Addiction (Substance Use Disorder) Counselor
- Charleston, WV
National Provider Identifier
1629721832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 2157 Greenbrier St
Charleston, WV 25311-9623 - Phone
- (304) 245-9750
- Fax
- (304) 344-3503
- NPI assigned
- Jan 28, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
2157 Greenbrier St
Charleston, WV 25311-9623
Mailing address
2157 Greenbrier St
Charleston, WV 25311-9623
Phone (304) 245-9750
Other practice location 1
2157 Greenbrier St
Charleston, WV 25311-9623
Phone (304) 245-9750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Medicaid | WV |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | @ctcprograms.com | Direct |
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
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1629721832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2157 GREENBRIER ST",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253119623",
"telephone_number": "304-245-9750",
"fax_number": "304-344-3503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2157 GREENBRIER ST",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253119623",
"telephone_number": "304-245-9750",
"fax_number": "304-344-3503"
}
],
"practiceLocations": [
{
"address_1": "2157 Greenbrier St",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "WV",
"postal_code": "253119623",
"country_code": "US",
"telephone_number": "304-245-9750",
"fax_number": "304-344-3503",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOOD",
"first_name": "DAVID",
"middle_name": "MATTHEW",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-28",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1",
"state": "WV"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "@ctcprograms.com",
"affiliation": "N",
"endpointDescription": "n/a",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2157 Greenbrier St",
"city": "Charleston",
"state": "WV",
"country_code": "US",
"postal_code": "253119623",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.