Healthcare Provider Details

I. General information

NPI: 1679517759
Provider Name (Legal Business Name): DEBRA ANN GOOD M.A., PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 NORTH THIRD STREET
HARRISBURG PA
17110
US

IV. Provider business mailing address

3235 NORTH THIRD STREET
HARRISBURG PA
17110
US

V. Phone/Fax

Practice location:
  • Phone: 717-234-3839
  • Fax: 717-234-6247
Mailing address:
  • Phone: 717-234-3839
  • Fax: 717-234-6247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPS006392L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS006392L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: