MEDICARE: EMILY L. GOODMAN PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184253502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMILY L. GOODMAN PC

Provider Business Mailing Address
First Line	:	701 P ST STE 303
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68508-1356
Country	:	US
Telephone Number	:	402-560-4156
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 P ST STE 303
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68508-1356
Country	:	US
Telephone Number	:	402-560-4156
Fax Number	:	402-267-4656

Authorized Official
Title or Position	:	OWNER
Name	:	EMILY L GOODMAN
Credential	:	LIMHP LADC
Telephone Number	:	402-560-4156

Provider Enumeration Date	:	04/07/2020
Last Update Date	:	02/02/2023

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Directions to “EMILY L. GOODMAN PC ” Practice Location

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