MEDICARE: LUCI ROSE GOODMAN LMHC

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	LH00008888	WA

General Provider Information

NPI Number	:	1902944937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCI ROSE GOODMAN LMHC

Provider Business Mailing Address
First Line	:	6527 21ST AVE NE APT 4
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-6959
Country	:	US
Telephone Number	:	206-349-7521
Fax Number	:

Provider Business Practice Location Address
First Line	:	6527 21ST AVE NE
Second Line	:	SUITE #4
City	:	SEATTLE
State	:	WA
Zip	:	98115-6959
Country	:	US
Telephone Number	:	206-349-7521
Fax Number	:

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	08/14/2025

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