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General NPI Number Information
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NPI Number | 1700923513
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Entity Type | Individual
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Provider Name | ROBIN GOODMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 720 W HILL ST
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City | LOUISVILLE
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State | KY
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Zip | 40208
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Country | US
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Telephone | 502-636-3164
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Fax | 502-634-3731
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-272-5448
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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 | 34004846A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | KY-813
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 813
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License Number State | KY
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