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NPI Code Detail

MEDICARE: GINA GOLDSTEIN LPC, M.S.

MEDICARE: GINA GOLDSTEIN LPC, M.S.
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
1101YP2500XProfessional Counselor003036CT

General Provider Information

NPI Number : 1376081273
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA GOLDSTEIN LPC, M.S.
Provider Business Mailing Address
First Line : 128 GARDEN ST
Second Line :
City : FARMINGTON
State : CT
Zip : 06032-2254
Country : US
Telephone Number : 860-716-5318
Fax Number : 860-231-8006
Provider Business Practice Location Address
First Line : 128 GARDEN ST
Second Line :
City : FARMINGTON
State : CT
Zip : 06032-2254
Country : US
Telephone Number : 860-716-5318
Fax Number : 860-231-8006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2017
Last Update Date : 02/10/2017

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