Active NPI
Burel Goodin
- Clinical Psychologist
- Birmingham, AL
National Provider Identifier
1780013557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1820
- Practice address
- 619 19TH St S
JT 807
Birmingham, AL 35249-6810 - Phone
- (205) 934-4696
- Fax
- (205) 934-9118
- NPI assigned
- Nov 2, 2013
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1820 | AL | Primary |
Addresses
Primary practice location
619 19TH St S
JT 807
Birmingham, AL 35249-6810
Mailing address
PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383350400000",
"number": "1780013557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55310",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555310",
"telephone_number": "205-731-9701",
"fax_number": "205-297-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 19TH ST S",
"address_2": "JT 807",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352496810",
"telephone_number": "205-934-4696",
"fax_number": "205-934-9118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODIN",
"first_name": "BUREL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-02",
"last_updated": "2013-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.