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General NPI Number Information
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NPI Number | 1801252861
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Entity Type | Organization
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Legal Business Name | ALAN GOOCH, LCSW, PLLC
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 225 WALTON AVE STE 124
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City | LEXINGTON
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State | KY
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Zip | 40502-1441
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Country | US
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Telephone | 859-402-2362
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Fax | 859-685-8345
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Provider Business Mailing Address
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Address Line | 225 WALTON AVE STE 124
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City | LEXINGTON
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State | KY
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Zip | 40502-1441
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Country | US
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Telephone | 859-402-2362
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Fax | 859-685-8345
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | MR. ALAN S GOOCH
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Credential | MSW, LCSW
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Telephone | 606-782-1895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3719
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License Number State | KY
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