MEDICARE: ANDREA GOOLAB LMHC

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
1	101YM0800X	Mental Health Counselor	MH25588	FL

General Provider Information

NPI Number	:	1306795851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA GOOLAB LMHC

Provider Business Mailing Address
First Line	:	4224 SW 71ST WAY
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-3146
Country	:	US
Telephone Number	:	954-736-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	4224 SW 71ST WAY
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-3146
Country	:	US
Telephone Number	:	954-736-7900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	04/15/2026

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