David Wayne Goodman, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

0852 Issued in NC

Practice address

2639 Sunset Avenue
Suite B
Rocky Mount, NC 27804-3700

Phone

(252) 937-4455

Fax

(252) 937-3060

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1982639803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 SUNSET AVENUE",
            "address_2": "SUITE B",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043700",
            "telephone_number": "252-937-4455",
            "fax_number": "252-937-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 SUNSET AVENUE",
            "address_2": "SUITE B",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043700",
            "telephone_number": "252-937-4455",
            "fax_number": "252-937-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "0852",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": "072002957",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "03624",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000021",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer B Godrich
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• David R Gorby, MD
• Andrew Merritt Gorham, DDS
• Ernest Alonza Gorham, APRN, PMHNP-BC
• Olivia Sue Gornichec, PA-C

• Counseling Psychologist in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Counseling Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.