MEDICARE: CELESTE RAY GOODMAN LCSW

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	1041C0700X	Clinical Social Worker	SW15209	FL

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	:	1689034613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTE RAY GOODMAN LCSW

Provider Business Mailing Address
First Line	:	9332 STATE ROAD 54 STE 307
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1810
Country	:	US
Telephone Number	:	833-769-3524
Fax Number	:	727-478-4966

Provider Business Practice Location Address
First Line	:	9332 STATE ROAD 54 STE 307
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1810
Country	:	US
Telephone Number	:	989-709-0269
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2016
Last Update Date	:	01/05/2026

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