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General NPI Number Information
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NPI Number | 1912770371
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Entity Type | Individual
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Provider Name | LEAH GOODCOFF LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 135 OLD COVE RD
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City | LIVERPOOL
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State | NY
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Zip | 13090-3767
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Country | US
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Telephone | 315-217-1144
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Fax |
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Provider Business Mailing Address
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Address Line | 11 KINGS CT APT 5
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City | CAMILLUS
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State | NY
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Zip | 13031-1751
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Country | US
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Telephone | 518-727-2441
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 014009
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License Number State | NY
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