MEDICARE: CRYSTA NADIEN GOODMAN RBT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		NC

General Provider Information

NPI Number	:	1740704279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTA NADIEN GOODMAN RBT

Provider Business Mailing Address
First Line	:	111 MACKENAN DR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-7903
Country	:	US
Telephone Number	:	919-371-2848
Fax Number	:

Provider Business Practice Location Address
First Line	:	5948 FISHER RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-5640
Country	:	US
Telephone Number	:	910-401-2870
Fax Number	:

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

Provider Enumeration Date	:	07/26/2017
Last Update Date	:	07/26/2017

Similar Medicare Providers

1578054805 — MOLLIE RICHARDSON PT, DPT
Practice Location Address:

5948 FISHER RD
FAYETTEVILLE, NC
28304-5640

Practice Phone: 910-423-5622
Practice Fax: 910-378-1755

1881921153 — ASSURED COMMUNITY SUPPORT INC
Practice Location Address:

5948 FISHER RD , 102B
FAYETTEVILLE, NC
28304-5640

Practice Phone: 910-223-0032
Practice Fax: 910-223-0255

1770943938 — JANICE WILLIAMS BCBA
Practice Location Address:

5948 FISHER RD
FAYETTEVILLE, NC
28304-5640

Practice Phone: 805-549-1484
Practice Fax: 910-766-6080

1164974937 — THERAPY PLAYGROUND, INC
Practice Location Address:

5948 FISHER RD
FAYETTEVILLE, NC
28304-5640

Practice Phone: 910-423-5622
Practice Fax: 910-378-1755

1790211357 — MICHELLE LYNN CHANCEY
Practice Location Address:

5948 FISHER RD , SUITE 201
FAYETTEVILLE, NC
28304-5640

Practice Phone: 910-401-2870
Practice Fax:

1992208466 — BRITTANY MARIE SKINNER OT
Practice Location Address:

5948 FISHER RD
FAYETTEVILLE, NC
28304-5640

Practice Phone: 910-423-4562
Practice Fax: 910-378-1755

Directions to “ CRYSTA NADIEN GOODMAN RBT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.