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General NPI Number Information
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NPI Number | 1518590637
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Entity Type | Individual
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Provider Name | ELLIOT RIVER GOODMAN MSW, LSW
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Gender |
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1201 S BRADDOCK AVE STE 2
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City | PITTSBURGH
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State | PA
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Zip | 15218-1275
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Country | US
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Telephone | 412-407-7642
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Fax |
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Provider Business Mailing Address
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Address Line | 305 7TH ST APT 62
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City | BRADDOCK
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State | PA
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Zip | 15104-1865
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Country | US
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Telephone | 412-965-8248
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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 | 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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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