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General NPI Number Information
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NPI Number | 1033482740
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Entity Type | Individual
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Provider Name | MICHAEL ALAN GOLDMAN M.ED., LPC
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Gender | Male
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 1005 CHERRY ST SUITE 202
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City | COLUMBIA
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State | MO
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Zip | 65201-7900
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Country | US
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Telephone | 573-864-5107
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Fax |
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Provider Business Mailing Address
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Address Line | 4751 MINOR HILL RD
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City | ASHLAND
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State | MO
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Zip | 65010-9628
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Country | US
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Telephone | 573-864-5107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CS000723
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License Number State | MO
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