Organization
MIDWEST PSYCHOLOGISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEN M. GOODMAN (CEO/PRESIDENT)
(270) 304-6643
Entity
Organization
Contact information
Practice address
2525 LINCOLN FARM RD, HODGENVILLE, KY 42748-9704
(270) 304-6643
(206) 888-6644
Mailing address
PO BOX 143, HODGENVILLE, KY 42748-0143
(270) 304-6643
(206) 888-6644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
08/30/2006
Last updated
09/11/2025
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