Provider Demographics
NPI:1174235683
Name:GOODNACK, ABBIGAIL ROSE ANN (PHD)
Entity type:Individual
Prefix:
First Name:ABBIGAIL
Middle Name:ROSE ANN
Last Name:GOODNACK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ABBIGAIL
Other - Middle Name:
Other - Last Name:RINARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:624 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-4515
Mailing Address - Country:US
Mailing Address - Phone:440-665-1537
Mailing Address - Fax:
Practice Address - Street 1:2539 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2328
Practice Address - Country:US
Practice Address - Phone:412-856-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATC015069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional