Healthcare Provider Details

I. General information

NPI: 1437013323
Provider Name (Legal Business Name): EVAN GOOD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MAIN ST PO BOX 962
STOCKBRIDGE MA
01262
US

IV. Provider business mailing address

25 MAIN ST PO BOX 962
STOCKBRIDGE MA
01262
US

V. Phone/Fax

Practice location:
  • Phone: 413-931-5836
  • Fax:
Mailing address:
  • Phone: 413-931-5836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10001960
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: