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1154288736 NPI number — EMILY B GOFORTH PLMHP, PMSW

NPI Number: 1154288736
Health Care Provider/Practitioner: EMILY B GOFORTH PLMHP, PMSW

Information about “1154288736” NPI (EMILY B GOFORTH PLMHP, PMSW) exists in 1154288736 in HTML format HTML  |  1154288736 in plain Text format TXT  |  1154288736 in PDF (Portable Document Format) PDF  |  1154288736 in an XML format XML  formats.

NPI Number : 1154288736 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154288736",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GOFORTH",
    "FirstName": "EMILY",
    "MiddleName": "B",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PLMHP, PMSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BAILEY",
    "OtherFirstName": "EMILY",
    "OtherMiddleName": "B",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 24607",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OMAHA",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68124-0607",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-955-5400",
    "MailingAddressFaxNumber": "402-955-3674",
    "FirstLinePracticeLocationAddress": "8550 INDIAN HILLS DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OMAHA",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68114-4070",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-955-3900",
    "PracticeLocationAddressFaxNumber": "402-955-3920",
    "EnumerationDate": "01/06/2026",
    "LastUpdateDate": "01/06/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "14705",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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