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General NPI Number Information
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NPI Number | 1558167221
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Entity Type | Organization
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Legal Business Name | GOODE THERAPY, LICENSED CLINICAL SOCIAL WORKER, INC.
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 517 3RD ST STE 40
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City | EUREKA
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State | CA
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Zip | 95501-0460
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Country | US
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Telephone | 707-502-2033
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Fax |
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Provider Business Mailing Address
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Address Line | 10 LONG ST
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City | EUREKA
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State | CA
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Zip | 95501-4181
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Country | US
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Telephone | 707-496-0453
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ASHLEY BRADSHAW
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Credential | LCSW, PMH-C, PPSC
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Telephone | 707-502-2033
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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 |
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License Number State |
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