| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHELBY GOODEN | 1104412840 | 2020-12-16 |
Shelby Gooden is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1104412840. Registration indicates Shelby Gooden is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, ) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Behavioral Analyst) (Behavioral Health & Social Service Providers, Behavioral Analyst) (Behavioral Analyst, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Behavioral Analyst, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | Shelby Gooden |
| Practice Office Address | 7440 HIGHWAY 92 WOODSTOCK, GA US |
| Practice Office Telephone | 7702122170 |
| Mailing Address | 911 N GOLIAD ST ROCKWALL, TX 750872230 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 3470 Florence Rd | Powder Springs, GA 301276026 | 7702122170 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician | RBT-18-70655
TX |
| 103K00000X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Behavioral Analyst Behavioral Health & Social Service Providers Behavioral Analyst Behavioral Analyst Behavioral Health/Substance Abuse/Psychiatry Behavioral Analyst Behavioral Health & Social Service Providers | 1-21-51429
TX |