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General NPI Number Information
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NPI Number | 1033808183
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Entity Type | Organization
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Legal Business Name | GOODINE COUNSELING LTD
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 2300 RIVERSIDE DR
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City | GREEN BAY
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State | WI
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Zip | 54301-1900
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Country | US
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Telephone | 920-362-0447
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Fax |
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Provider Business Mailing Address
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Address Line | 2123 NELLIE LN
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City | GREEN BAY
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State | WI
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Zip | 54311-6068
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Country | US
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Telephone | 920-660-9797
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH ANN GOODINE
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Credential | LPC
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Telephone | 920-660-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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