Healthcare Provider Details

I. General information

NPI: 1932034253
Provider Name (Legal Business Name): GILLIAN GOODHUE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1253 PANAMA DR
SARASOTA FL
34234-7445
US

IV. Provider business mailing address

1253 PANAMA DR
SARASOTA FL
34234-7445
US

V. Phone/Fax

Practice location:
  • Phone: 941-233-0623
  • Fax:
Mailing address:
  • Phone: 941-233-0623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27752
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: