BOBBY GOODMAN (NPI# 1003342478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003342478 |
| Entity Type | Individual |
| Full Name | BOBBY GOODMAN |
| Credential | M.A. MAADCII MARS |
| Practice Address |
1109 Jones St Kennett MO 63857-3824 |
| Practice Telephone | 5738885925 |
| Mailing Telephone | 5738885925 |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2017-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1109 JONES ST |
| City | KENNETT |
| State | MO |
| Zip Code | 63857-3824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013023860 | Carl Rodney Fisher | Counselor | 1109 Jones St, Kennett, MO 63857-3824 | 2006-08-22 |
| 1588265565 | Jaymie Rena Glass | Case Manager/Care Coordinator | 1109 Jones St, Kennett, MO 63857-3824 | 2020-11-05 |
| 1205468402 | James Berry Rogers | Behavior Technician | 1109 Jones St, Kennett, MO 63857-3824 | 2020-02-06 |
| 1528698156 | Dylon Deauston Holt | Behavior Technician | 1109 Jones St, Kennett, MO 63857-3824 | 2020-01-23 |
| 1598305351 | Lora Nicole Wilson | Counselor | 1109 Jones St, Kennett, MO 63857-3824 | 2020-01-09 |
| 1336799428 | William Robert Davis Jr. | Behavior Technician | 1109 Jones St, Kennett, MO 63857-3824 | 2019-09-19 |
| 1013564947 | Chelsi Joann Masterson | Case Manager/Care Coordinator | 1109 Jones St, Kennett, MO 63857-3824 | 2019-08-26 |
| 1790337442 | Kelsi Michelle Moody | Behavior Technician | 1109 Jones St, Kennett, MO 63857-3824 | 2019-07-12 |
| 1649839002 | James Mark Howell | Behavior Technician | 1109 Jones St, Kennett, MO 63857-3824 | 2019-06-10 |
| 1497313308 | Jacqueline Michelle Morris | Health Educator | 1109 Jones St, Kennett, MO 63857-3824 | 2019-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278139 | Fancilla Adams | Counselor | 925 State Highway V V, Kennett, MO 63857 | 2019-01-10 |
| 1962994418 | Kiana Alexis Brown | Behavior Technician | 925 Highway W, Kennett, MO 63857 | 2018-05-31 |
| 1568953636 | Doctors Health Group, Inc | Family Medicine | 1312 First Street, Kennett, MO 63857 | 2018-05-24 |
| 1003328873 | Ann Graf | Counselor | 925 Vv, Kennett, MO 63857 | 2017-11-01 |
| 1457872160 | Jessica Luster | Technician, Other | 1109 Jones St., Kennett, MO 63857 | 2017-07-03 |
| 1235669128 | Chandra Celeste Perkins-shannon | Case Manager/Care Coordinator | 925 Hwy V, Kennett, MO 63857 | 2017-06-14 |
| 1467991612 | Sarah Lobdell | Case Manager/Care Coordinator | 925 State Highway Vv, Kennett, MO 63857 | 2017-02-21 |
| 1881132900 | Brandy Rios | Community Health Worker | 935 State Hwy Vv, Kennett, MO 63857 | 2017-02-09 |
| 1295272060 | Johnny Marie Johnson | Case Manager/Care Coordinator | 925 Hwy Vv Family Counseling Center, Kennett, MO 63857 | 2017-01-31 |
| 1043756364 | Heather Bowman | Case Manager/Care Coordinator | 875 Hwy Vv, Kennett, MO 63857 | 2017-01-10 |
| Find all providers in zip 63857 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659733418 | Robert Kelsey | Counselor | 232 Vandeventer Place, Kennett, MO 63857 | 2016-03-22 |
| 1568738151 | Morgan Brewer | Counselor | 607 Teaco Road, Kennett, MO 63857-3423 | 2012-03-28 |
| 1265528921 | Adrienne Elois Calvert | Counselor | 925 Hwy Vv, Kennett, MO 63857 | 2006-10-04 |
| 1033718804 | Jaclyn Stafford | Counselor | 925 Highway Vv, Kennett, MO 63857 | 2020-10-22 |
| 1780210088 | Legusta Renee Perkins | Counselor | 935 State Route Vv, Kennett, MO 63857-3822 | 2020-03-18 |
| 1275006306 | Stephanie Leeann Skelton | Counselor | 1109 Jones St, Kennett, MO 63857-3824 | 2019-01-11 |
| 1528542529 | Jennifer Dee Sanchez | Counselor | 935 State Route Vv, Kennett, MO 63857-3822 | 2018-09-17 |
| 1396234159 | Felicia Diane Green | Counselor | 925 Highway Vv, Kennett, MO 63857 | 2018-05-08 |
| 1740780485 | Desmond Frederic Hammett | Counselor | 925 Hwy Vv, Kennett, MO 63857 | 2018-02-20 |
| 1508310293 | Success Health System, LLC | Counselor | 607 Teaco Rd, Kennett, MO 63857-3723 | 2016-08-10 |
| Find all providers in KENNETT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.