Active NPI
Dale R. Goodman
- Pastoral Counselor
- Alpharetta, GA
National Provider Identifier
1932546132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 2343
- Practice address
- 4080 McGinnis Ferry Rd
204
Alpharetta, GA 30005-3948 - Phone
- (678) 860-0498
- NPI assigned
- May 28, 2013
- Last updated
- May 28, 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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 2343 | FL | Primary |
Addresses
Primary practice location
4080 McGinnis Ferry Rd
204
Alpharetta, GA 30005-3948
Mailing address
4080 McGinnis Ferry Rd
204
Alpharetta, GA 30005-3948
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2343 | FL | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369699200000",
"number": "1932546132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4080 MCGINNIS FERRY RD",
"address_2": "204",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300053948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4080 MCGINNIS FERRY RD",
"address_2": "204",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300053948",
"telephone_number": "678-860-0498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "DALE",
"middle_name": "R.",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-28",
"last_updated": "2013-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "FL",
"license": "2343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alpharetta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.