MEDICARE: RASHIDA GOODE

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	1041C0700X	Clinical Social Worker	Q1-0001625	DE

General Provider Information

NPI Number	:	1790172138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHIDA GOODE

Provider Business Mailing Address
First Line	:	1050 REGISTER ST BLDG 27
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29405-2421
Country	:	US
Telephone Number	:	786-295-2353
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 REGISTER ST BLDG 27
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29405-2421
Country	:	US
Telephone Number	:	786-295-2353
Fax Number	:

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

Provider Enumeration Date	:	04/23/2015
Last Update Date	:	04/08/2022

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