Healthcare Provider Details

I. General information

NPI: 1073280111
Provider Name (Legal Business Name): VALERIE GOODALE FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 W 26TH ST
JOPLIN MO
64804-1904
US

IV. Provider business mailing address

705 W 26TH ST
JOPLIN MO
64804-1904
US

V. Phone/Fax

Practice location:
  • Phone: 417-627-9994
  • Fax: 417-627-9995
Mailing address:
  • Phone: 417-627-9994
  • Fax: 417-627-9995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2021033947
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2024025462
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: