Healthcare Provider Details

I. General information

NPI: 1255253183
Provider Name (Legal Business Name): BENJAMIN J GOLDMAN LPCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 S 7TH ST STE 100
LOUISVILLE KY
40203-1981
US

IV. Provider business mailing address

8802 FURLONG DR APT 13
LYNDON KY
40242-7521
US

V. Phone/Fax

Practice location:
  • Phone: 502-881-1742
  • Fax:
Mailing address:
  • Phone: 502-232-0450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number301951
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: