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General NPI Number Information
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NPI Number | 1821978859
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Entity Type | Individual
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Provider Name | ROBERT WHITNEY GOODELL III LPC
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Gender | Male
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3347 N WINDSONG DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2283
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Country | US
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Telephone | 928-445-5211
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 STETSON RD APT 5
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City | PRESCOTT
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State | AZ
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Zip | 86303-3358
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Country | US
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Telephone | 928-710-1028
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-24072
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License Number State | AZ
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