Healthcare Provider Details

I. General information

NPI: 1548313042
Provider Name (Legal Business Name): DEBRA JEAN GOTEN LMHC LADCL LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 UNION ST 1 SW
NEW BEDFORD MA
02740-3679
US

IV. Provider business mailing address

8 PEARL ST
S DARTMOUTH MA
02748
US

V. Phone/Fax

Practice location:
  • Phone: 508-994-0848
  • Fax: 508-994-0844
Mailing address:
  • Phone: 508-990-0907
  • Fax: 508-990-0907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1757
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number248
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number310240
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: