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General NPI Number Information
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NPI Number | 1407191562
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Entity Type | Individual
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Provider Name | DAVID NEAL GOLDSTEIN LCPC 6008
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Gender | Male
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 847 PARKCENTRE WAY STE 4
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City | NAMPA
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State | ID
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Zip | 83651-1794
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Country | US
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Telephone | 208-467-2673
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Fax |
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Provider Business Mailing Address
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Address Line | 1843 E MEADOWGRASS ST
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City | MERIDIAN
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State | ID
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Zip | 83646-7314
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Country | US
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Telephone | 407-666-8911
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH9472
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCPC 6008
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CADC 10268
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC 6008
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License Number State | ID
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