TYLER WADE GOODMAN
NPI 1124884242
Peer Specialist in Ponca City, OK

Active since February 26, 2024
93 NOEL LN, PONCA CITY, OK 74604(580) 485-5796 Get Directions Write a Review

NPPES record last updated: March 20, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tyler Wade Goodman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER WADE GOODMAN (NPI 1124884242) is an individual peer specialist in Ponca City, Oklahoma and active in the NPI registry since February 2024. He maintains a secondary practice location in Ponca City.

NPPES Registry Identity

NPI1124884242
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameTYLER WADE GOODMAN
Location Address93 NOEL LNPonca City, OK 74604-5443
Mailing AddressGrand Mental Health 407 S AvePonca City, OK 74604-5443 · (580) 485-5796
Sole ProprietorNo
Enumeration DateFebruary 26, 2024
Last NPPES UpdateMarch 20, 2024
NPPES CertifiedMarch 20, 2024
NPI 1124884242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

93 NOEL LN, Ponca City, OK 74604

Secondary Practice Location 1

Location 193 Noel LnPonca City, OK 74604-5443 · Phone (580) 485-5796

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Goodman's NPI number?

The NPI number for Tyler Goodman is 1124884242. It was assigned to this individual provider in the NPPES registry on February 26, 2024.

Where is Tyler Goodman located?

Tyler Goodman practices at 93 Noel Ln, Ponca City, OK 74604. The listed phone number is (580) 485-5796.

What is Tyler Goodman's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Tyler Goodman was last updated on March 20, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.