Healthcare Provider Details

I. General information

NPI: 1396337010
Provider Name (Legal Business Name): GOODMAN COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 COTTAGE RD
WAYLAND MA
01778-4406
US

IV. Provider business mailing address

8 COTTAGE RD
WAYLAND MA
01778-4406
US

V. Phone/Fax

Practice location:
  • Phone: 561-309-5230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ADAM GOODMAN
Title or Position: MANAGER
Credential: LMFT
Phone: 561-309-5230