Provider Demographics
NPI:1679517759
Name:GOOD, DEBRA ANN (MA, PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:GOOD
Suffix:
Gender:F
Credentials:MA, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 NORTH THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110
Mailing Address - Country:US
Mailing Address - Phone:717-234-3839
Mailing Address - Fax:717-234-6247
Practice Address - Street 1:3235 NORTH THIRD STREET
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110
Practice Address - Country:US
Practice Address - Phone:717-234-3839
Practice Address - Fax:717-234-6247
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0400X, 103TC1900X
PAPS006392L103TA0400X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)