SHERYL P GOODALL (NPI# 1518948629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518948629 |
| Entity Type | Individual |
| Full Name | SHERYL P GOODALL |
| Credential | NP |
| Practice Address |
830 Oak St Suite 105w Brockton MA 02301-1168 |
| Practice Telephone | 5084273668 |
| Practice Fax Number | 5084272610 |
| Mailing Telephone | 5084273668 |
| Mailing Fax Number | 5084272610 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2008-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
170600 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
170600 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0355241 | 05 | |
| MA | BLUE CROSS | PN0849 | 01 |
| MA | HEALTHNET | 28308 | 01 |
| MA | TUFTS | 616882 | 01 |
| Street Address |
830 OAK ST SUITE 105W |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-1168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740288943 | Shreekant Chopra | Internal Medicine | 830 Oak St, 125e, Brockton, MA 02301-1168 | 2005-07-12 |
| 1215279039 | Hoch LLC | Obstetrics & Gynecology | 830 Oak St, Ste 102w, Brockton, MA 02301 | 2013-03-19 |
| 1104116458 | Esp Med LLC | Internal Medicine | 830 Oak St, Suite 102w, Brockton, MA 02301-1168 | 2011-04-07 |
| 1548592934 | Esp Medical LLC | Internal Medicine | 830 Oak St, Suite 102w, Brockton, MA 02301-1168 | 2010-02-10 |
| 1548416449 | Irma A Alarcon Najera | Internal Medicine | 830 Oak St, Suite 105w, Brockton, MA 02301-1168 | 2008-08-11 |
| 1306029970 | Amy E Harding | Nurse Practitioner | 830 Oak St, Suite 223e, Brockton, MA 02301-1168 | 2007-12-06 |
| 1629106679 | Uma A. Dhanabalan | Clinic/Center | 830 Oak St, Brockton, MA 02301-1168 | 2007-03-01 |
| 1912048414 | Renal Medical Care, PC | Internal Medicine | 830 Oak St, Suite 125e, Brockton, MA 02301-1168 | 2007-02-09 |
| 1558427070 | Hanjani PC | Obstetrics & Gynecology | 830 Oak St, Ste 201w, Brockton, MA 02301-1168 | 2006-12-29 |
| 1386700706 | Shenbagavali Ramaswami, Md | Obstetrics & Gynecology | 830 Oak St, Ste 102w, Brockton, MA 02301-1168 | 2006-12-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831427632 | Leslie Ann Delisle | Clinical Nurse Specialist | 22 Christy Dr, Brockton, MA 02301-1839 | 2009-12-07 |
| 1487888509 | Linda M Meehan | Clinical Nurse Specialist | 529 Pearl Street, Brockton, MA 02301 | 2009-05-04 |
| 1285843342 | Starr Psychiatric Center, Inc. | Clinical Nurse Specialist | 529 Pearl St, Brockton, MA 02301-2825 | 2007-05-22 |
| 1891858213 | Dawn E Herman | Clinical Nurse Specialist | 7 Christys Drive, Suite 3, Brockton, MA 02301 | 2006-12-18 |
| 1750476412 | Cynthia Medich | Clinical Nurse Specialist | 529 Pearl St, Brockton, MA 02301-2825 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935809 | Anne-marie Barron | Clinical Nurse Specialist | 9 Kahler Ave, Milton, MA 02186-1519 | 2020-06-07 |
| 1306467139 | Kathleen Mary Daly | Clinical Nurse Specialist | 22 Priscilla Ln, Duxbury, MA 02332-5101 | 2020-05-04 |
| 1407325541 | New Directions Behavioral Health LLC | Clinical Nurse Specialist | 10 Ash St, Danvers, MA 01923-2749 | 2018-11-19 |
| 1457894628 | Psyche1001 Learn Grow Change LLC | Clinical Nurse Specialist | 638 Adamsville Rd, Suite 1001, Westport, MA 02790-5031 | 2016-11-21 |
| 1841642725 | Joyce Daqnal Shields | Clinical Nurse Specialist | 132 Oakley Rd, Belmont, MA 02478-2734 | 2016-07-05 |
| 1386004075 | Jane Bloom | Clinical Nurse Specialist | 95 Golden Hill, Lee, MA 01238-9132 | 2016-02-24 |
| 1255722716 | Carol Vivori | Clinical Nurse Specialist | 132 Mass Moca Way, North Adams, MA 01247-2446 | 2015-02-05 |
| 1982995262 | Linda Louise Darbyshire | Clinical Nurse Specialist | 60 Munson Meeting Way Ste I, Psychiatric Collaborative, Chatham, MA 02633-1992 | 2011-04-21 |
| 1093020091 | Suzanne Elizabeth Bergeron | Clinical Nurse Specialist | 2 Administration Rd, Bridgewater, MA 02324-3230 | 2010-08-13 |
| 1467774356 | Mindful Wellbeing, LLC | Clinical Nurse Specialist | 11 Jillson Way, East Sandwich, MA 02537-1265 | 2010-02-19 |
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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.