Healthcare Provider Details

I. General information

NPI: 1588664163
Provider Name (Legal Business Name): DAVID ARTHUR GOOLSBY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID ARTHUR MORGAN-GOOLSBY LCSW-CC

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26B ENFIELD RD
LINCOLN ME
04457-1190
US

IV. Provider business mailing address

PO BOX 700
LINCOLN ME
04457
US

V. Phone/Fax

Practice location:
  • Phone: 207-794-8990
  • Fax: 207-403-9093
Mailing address:
  • Phone: 207-794-8990
  • Fax: 207-403-9093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC6715
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: