Healthcare Provider Details

I. General information

NPI: 1407509623
Provider Name (Legal Business Name): EMMA L QUADLANDER-GOFF PH.D., LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 W TROY ST
DOTHAN AL
36303-4455
US

IV. Provider business mailing address

644 COUNTY ROAD 19
HEADLAND AL
36345-6198
US

V. Phone/Fax

Practice location:
  • Phone: 334-336-4468
  • Fax:
Mailing address:
  • Phone: 512-592-0821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC04999
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: