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NPI 1730451410

NPI 1730451410 : CINDY SUE GOLDMAN M.ED., L.P.C., N.C.C : SOUTHFIELD, MI

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General NPI Number Information
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    NPI Number           |    1730451410
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    Entity Type          |    Individual 
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    Provider Name        |    CINDY SUE GOLDMAN M.ED., L.P.C., N.C.C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/27/2012
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    Last Update Date     |    09/16/2015
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Provider Practice Location Address
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    Address Line         |    26877 NORTHWESTERN HWY SUITE120
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    City                 |    SOUTHFIELD
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    State                |    MI
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    Zip                  |    48033-2141
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    Country              |    US
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    Telephone            |    248-320-1750
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6059 MISSION DR SUITE 220
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    City                 |    WEST BLOOMFIELD
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    State                |    MI
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    Zip                  |    48324-3312
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    Country              |    US
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    Telephone            |    248-320-1750
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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       |    6401008503
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    License Number State |    MI
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