=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366393373
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMBER LYNN GOODSON MS,LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2026
-----------------------------------------------------
Last Update Date | 02/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1921 STONECIPHER DR
-----------------------------------------------------
City | ADA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74820-3439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-436-3980
-----------------------------------------------------
Fax | 580-272-5757
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 124 E MAIN ST STE B4
-----------------------------------------------------
City | ADA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74820-5623
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-436-7206
-----------------------------------------------------
Fax | 580-272-5757
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 11270
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------