SARAH GOODNER


Address: 1704 Royal Pointe Drive, Bloomington, IL 61704
Phone: 3092531807

SARAH GOODNER (NPI# 1649798513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649798513
Entity Type Individual
Full Name SARAH GOODNER
Practice Address 1704 Royal Pointe Drive
Bloomington
IL 61704
Mailing Address 1704 Royal Pointe Dr
Bloomington
IL 61704-8170
Practice Telephone 3092531807
Enumeration Date 2017-08-31
Last Update Date 2017-08-31
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TS0200X Psychologist
Specialization: School
2022001 IL Behavioral Health & Social Service Providers

Office Location

Street Address 1704 ROYAL POINTE DRIVE
City BLOOMINGTON
State IL
Zip Code 61704

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Taxonomy Information

Taxonomy Code 103TS0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization School

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City BLOOMINGTON
Zip Code 61704

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Dataset Information

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.

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