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General NPI Number Information
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NPI Number | 1669367066
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Entity Type | Individual
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Provider Name | ELIZABETH ELLEN GOFF
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 8620 W EMERALD ST STE 150
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City | BOISE
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State | ID
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Zip | 83704-4839
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Country | US
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Telephone | 208-617-3265
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Fax |
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Provider Business Mailing Address
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Address Line | 5519 N BRIGADOON AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-1126
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Country | US
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Telephone | 208-284-6594
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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 | 7371566
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License Number State | ID
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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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