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General NPI Number Information
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NPI Number | 1700630696
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Entity Type | Individual
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Provider Name | KRISTI LEAH GOLDADE LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/16/2024
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 313 PRICE PL STE 113
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City | MADISON
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State | WI
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Zip | 53705-3262
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Country | US
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Telephone | 701-640-9544
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Fax |
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Provider Business Mailing Address
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Address Line | 518 DIVING HAWK TRL
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City | MADISON
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State | WI
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Zip | 53713-3380
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Country | US
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Telephone | 701-640-9544
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11716123
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License Number State | WI
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