Healthcare Provider Details

I. General information

NPI: 1609339290
Provider Name (Legal Business Name): LAUREN NICOLE GOFF LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. LAUREN NICOLE FORDE

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 05/21/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15235 SPRING CYPRESS RD.
CYPRESS TX
77429
US

IV. Provider business mailing address

134 VINTAGE PARK BLVD STE A #389
HOUSTON TX
77070
US

V. Phone/Fax

Practice location:
  • Phone: 832-317-6360
  • Fax: 832-652-3626
Mailing address:
  • Phone: 832-317-6360
  • Fax: 832-652-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number77507
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: