Healthcare Provider Details

I. General information

NPI: 1245306562
Provider Name (Legal Business Name): JOY GOODIE DNP, CRNP-PMH, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8665 GEORGIA AVE
SILVER SPRING MD
20910-3405
US

IV. Provider business mailing address

103 LOCUST DR
BALTIMORE MD
21207-6021
US

V. Phone/Fax

Practice location:
  • Phone: 410-905-4948
  • Fax:
Mailing address:
  • Phone: 410-905-4948
  • Fax: 410-594-1732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC1643
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR258039
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: