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NPI Code Detail

MEDICARE: MS. DONNA L. GOCH LPC, CAADC

MEDICARE: MS. DONNA L. GOCH LPC, CAADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorC-00067MI
2101YP2500XProfessional Counselor6401010491MI

General Provider Information

NPI Number : 1093958662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DONNA L. GOCH LPC, CAADC
Provider Business Mailing Address
First Line : 622 E GRAND RIVER AVE
Second Line :
City : HOWELL
State : MI
Zip : 48843-2329
Country : US
Telephone Number : 517-548-0081
Fax Number : 517-548-0498
Provider Business Practice Location Address
First Line : 622 E GRAND RIVER AVE
Second Line :
City : HOWELL
State : MI
Zip : 48843-2329
Country : US
Telephone Number : 517-548-0081
Fax Number : 517-548-0498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2009
Last Update Date : 12/09/2013

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