MEDICARE: PORCHE L GOODMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	171400000X	Health & Wellness Coach
3	171M00000X	Case Manager/Care Coordinator
4	174N00000X	Lactation Consultant (Non-RN)
5	374J00000X	Doula

General Provider Information

NPI Number	:	1972468817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PORCHE L GOODMAN

Provider Business Mailing Address
First Line	:	1735 NORTHSTAR RD APT 2212
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-1672
Country	:	US
Telephone Number	:	225-348-3060
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 NORTHSTAR RD APT 2212
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-1672
Country	:	US
Telephone Number	:	225-348-3060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

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Directions to “ PORCHE L GOODMAN ” Practice Location

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