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General NPI Number Information
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NPI Number | 1871630129
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Entity Type | Organization
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Legal Business Name | CINDY GOFF, PLLC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2235 E 25TH ST STE 160
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7538
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Country | US
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Telephone | 208-523-4820
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Fax | 208-522-9859
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Provider Business Mailing Address
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Address Line | PO BOX 3815
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City | IDAHO FALLS
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State | ID
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Zip | 83403-3815
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Country | US
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Telephone | 208-525-2090
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Fax | 208-525-2662
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Authorized Official
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Title or Position | OWNER
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Name | CINDY GOFF
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Credential | LPCP
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Telephone | 208-523-4820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCPC-267
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License Number State | ID
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