Healthcare Provider Details

I. General information

NPI: 1447744578
Provider Name (Legal Business Name): LACHELLE G GOODRICH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 ROSEBROOK DR
MANSFIELD TX
76063-7503
US

IV. Provider business mailing address

1311 ROSEBROOK DR
MANSFIELD TX
76063-7503
US

V. Phone/Fax

Practice location:
  • Phone: 817-372-0353
  • Fax: 817-585-4064
Mailing address:
  • Phone: 817-372-0353
  • Fax: 817-585-4064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number76671
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: