Provider Demographics
NPI:1316660442
Name:GOODE, ABIGAIL JUSTINE
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JUSTINE
Last Name:GOODE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6833 WESTBURY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7058
Mailing Address - Country:US
Mailing Address - Phone:817-707-2801
Mailing Address - Fax:
Practice Address - Street 1:1901 CENTRAL DR STE 160
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5823
Practice Address - Country:US
Practice Address - Phone:682-289-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606071041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical