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General NPI Number Information
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NPI Number | 1376252924
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Entity Type | Organization
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Legal Business Name | GOODWERK & COMPANY LLC
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 19 W 34TH ST
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 646-971-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 374 7TH AVE W UNIT 7010
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City | NEWARK
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State | NJ
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Zip | 07107-7001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ALFONSO LLEWELLYN FERGUSON
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Credential | PHD, LMHC, LPC
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Telephone | 646-971-0512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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