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General NPI Number Information
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NPI Number | 1588047237
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Entity Type | Individual
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Provider Name | CHERJUAN YVETTE GOODMAN LPC, CRC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 4130 N LINCOLN BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73105-5209
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Country | US
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Telephone | 405-424-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 5104 NE 38TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73121-6409
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Country | US
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Telephone | 405-514-6893
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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 | LPC CANDIDATE
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6917
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License Number State | OK
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