Healthcare Provider Details
I. General information
NPI: 1841155223
Provider Name (Legal Business Name): ELIZABETH GOODELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
221 E 3RD ST
ALLIANCE NE
69301-3825
US
IV. Provider business mailing address
PO BOX 651
ALLIANCE NE
69301-0651
US
V. Phone/Fax
- Phone: 308-763-9261
- Fax: 308-275-2042
- Phone: 308-763-9261
- Fax: 308-275-2042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 14687 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: