DR. JERROLD WILLIAM GOODMAN (NPI# 1326265372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326265372 |
| Entity Type | Individual |
| Full Name | DR. JERROLD WILLIAM GOODMAN |
| Credential | PH.D. |
| Practice Address |
68 S Main St Suite 200 West Hartford CT 06107-2445 |
| Practice Telephone | 8605616178 |
| Practice Fax Number | 8605616184 |
| Mailing Telephone | 8605616178 |
| Mailing Fax Number | 8605616184 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
CT000414 | CT | Behavioral Health & Social Service Providers |
| Street Address |
68 S MAIN ST SUITE 200 |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06107-2445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235646316 | Jill Shalan, Phd, Pllc | Psychologist | 68 S Main St, West Hartford, CT 06107-2445 | 2018-01-10 |
| 1811379662 | Peter Tolisano Psyd LLC | Community/Behavioral Health | 68 S Main St, Suite 100, West Hartford, CT 06107-2445 | 2015-06-28 |
| 1033527312 | Louis Graff LLC | Clinic/Center | 68 S Main St, Suite 201, West Hartford, CT 06107-2445 | 2014-07-30 |
| 1902111073 | Raymond L Almeida Lcsw LLC | Social Worker | 68 S Main St, Suite 200, West Hartford, CT 06107-2445 | 2010-08-13 |
| 1154485456 | Eleanor A Hirtreiter | Psychologist | 68 S Main St, Suite 202, West Hartford, CT 06107-2445 | 2006-12-20 |
| 1275633521 | Joan C Miller | Social Worker | 68 S Main St, West Hartford, CT 06107-2445 | 2006-09-25 |
| 1407861867 | Evelyn Diane Kirkman | Social Worker | 68 S Main St, Suite 202, West Hartford, CT 06107-2445 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538783659 | Briana Deslauriers | Audiologist | Solinsky Hearing Center, 1013 Farmington Avenue, West Hartford, CT 06107 | 2020-06-04 |
| 1750851366 | Candyce Yvonne Scott | Counselor | 61 S Main St Ste 310, West Hartford, CT 06107 | 2018-11-27 |
| 1124524798 | Image of Light Mental Health Services, LLC | Nurse Practitioner | 45 S Main St Ste 70, West Hartford, CT 06107 | 2018-04-03 |
| 1235632498 | Leila Fussell | Student in an Organized Health Care Education/Training Program | 175 Garfield Rd, West Hartford, CT 06107 | 2018-03-14 |
| 1568818169 | Gail Southard Canzano | Psychologist | 81 S. Main St, West Hartford, CT 06107 | 2016-05-12 |
| 1922470939 | Optimal Wellness of West Hartford | Family Medicine | 1001 Farmington Ave., West Hartford, CT 06107 | 2015-10-29 |
| 1518369925 | Maria Eugenia Garcia-ayala | Psychiatry & Neurology | 65 Memorial Rd Ste 508, West Hartford, CT 06107 | 2014-09-17 |
| 1376884981 | Robert Moss | Pediatrics | 174 Wood Pond Road, West Hartford, CT 06107 | 2013-03-06 |
| 1659630960 | Michael John Grille | Anesthesiology | 65 Memorial Rd #435, Hartford Hospital Pain Treatment Center, West Hartford, CT 06107 | 2012-05-07 |
| 1518268010 | Parsons Health Co. Inc | Legal Medicine | 61 So Main Street, Suite 202, West Hartford, CT 06107 | 2010-11-15 |
| Find all providers in zip 06107 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376004481 | Frank J Stoll, Ph.d., LLC | Psychologist | 18 N Main St Fl 3, West Hartford, CT 06107-1970 | 2019-03-29 |
| 1053804575 | Daniel James Martin | Psychologist | 19 Linwold Dr, West Hartford, CT 06107-1237 | 2018-06-09 |
| 1568818169 | Gail Southard Canzano | Psychologist | 81 S. Main St, West Hartford, CT 06107 | 2016-05-12 |
| 1669856555 | Noah Joseph Bluestone | Psychologist | 68 Soutth Main St, Suite 202, West Hartford, CT 06117 | 2015-07-10 |
| 1417200825 | Nicole Reilly Hill | Psychologist | 998 Farmington Ave Ste 109, West Hartford, CT 06107-2184 | 2012-10-23 |
| 1437454717 | Jacqueline Guajardo | Psychologist | 73 Foxridge Rd, West Hartford, CT 06107-3625 | 2011-01-19 |
| 1205140803 | Jason Alan Gockel | Psychologist | 41 S Main St Ste 7, West Hartford, CT 06107-2448 | 2010-08-06 |
| 1225341696 | Ira Potashner | Psychologist | 61 S Main St Ste 209, West Hartford, CT 06107-2403 | 2010-07-14 |
| 1730391830 | Jessica A Mitchell-corsino | Psychologist | 45 S Main St Ste 303, West Hartford, CT 06107-2402 | 2007-05-03 |
| 1457579583 | Kathy A Mccloskey | Psychologist | 200 Bloomfield Avenue, University of Hartford, West Hartford, CT 06117 | 2007-04-23 |
| Find all providers in WEST HARTFORD | ||||
| City | WEST HARTFORD |
| Zip Code | 06107 |
Please comment or provide details below to improve the information on DR. JERROLD WILLIAM GOODMAN.
| 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.