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NPI Code Detail

MEDICARE: MRS. CORENE CREE MCGOODEN LCSW

MEDICARE: MRS. CORENE CREE MCGOODEN LCSW
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
11041C0700XClinical Social WorkerSW7061FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235294158
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CORENE CREE MCGOODEN LCSW
Provider Business Mailing Address
First Line : 2911 ROBERTS AVE UNIT B
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32310-5007
Country : US
Telephone Number : 850-644-1543
Fax Number : 855-230-7421
Provider Business Practice Location Address
First Line : 2911 ROBERTS AVE
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32310-5007
Country : US
Telephone Number : 850-644-1543
Fax Number : 855-230-7421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 07/06/2022

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Directions to “ MRS. CORENE CREE MCGOODEN LCSW” Practice Location

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