Individual provider Active NPI

David Daniel Goodrick, PHD

  • Clinical Psychologist
  • Hillsboro Beach, FL
National Provider Identifier
1982283578
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
490-57 Issued in WI
Practice address
1039 Hillsboro Mile Apt 4
Hillsboro Beach, FL 33062-2104
Phone
(954) 815-6227
NPI assigned
Apr 2, 2021
Last updated
Apr 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 490-57 WI Primary

Addresses

Primary practice location

1039 Hillsboro Mile Apt 4
Hillsboro Beach, FL 33062-2104

Mailing address

1039 Hillsboro Mile Apt 4
Hillsboro Beach, FL 33062-2104
Phone (954) 815-6227

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
490-57WIMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1982283578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 HILLSBORO MILE APT 4",
            "city": "HILLSBORO BEACH",
            "state": "FL",
            "postal_code": "330622104",
            "telephone_number": "954-815-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 HILLSBORO MILE APT 4",
            "city": "HILLSBORO BEACH",
            "state": "FL",
            "postal_code": "330622104",
            "telephone_number": "954-815-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICK",
        "first_name": "DAVID",
        "middle_name": "DANIEL",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "490-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.