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General NPI Number Information
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NPI Number | 1902250418
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Entity Type | Individual
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Provider Name | NATHAN GOLTSMAN
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Gender | Male
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 7301 N. 16TH ST STE 102 - #4457
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City | PHOENIX
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State | AZ
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Zip | 85020
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Country | US
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Telephone | 602-851-8188
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9457
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City | PHOENIX
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State | AZ
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Zip | 85068-9457
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Country | US
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Telephone | 602-821-8818
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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-19085
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License Number State | AZ
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