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General NPI Number Information
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NPI Number | 1902817208
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Entity Type | Individual
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Provider Name | LEAH MARIE GOODNOW LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 920 EAST BATIMORE PIKE SUITE 200 HOLCOMB BHS
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City | KENNETT SQUARE
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State | PA
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Zip | 19348
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Country | US
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Telephone | 610-388-9225
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Fax | 610-388-3224
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Provider Business Mailing Address
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Address Line | 920 EAST BALTIMORE PIKE SUITE 200 HOLCOMB BHS
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City | KENNETT SQUARE
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State | PA
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Zip | 19348
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Country | US
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Telephone | 610-388-9225
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Fax | 610-388-3224
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW124994
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015834
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License Number State | PA
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