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Individual
SHARON L GOEDKOOP
Active
Individual
SHARON L GOEDKOOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, PLLC
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
0890001132
VT
1041C0700X
Clinical Social Worker
Primary
0890001132
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013257484
BLUE CROSS/BLUE SHIELD
VT
05
—
1021546
—
VT
05
—
3086010
—
NH
01
—
4583988
CIGNA
VT
Enumeration date
02/22/2013
Last updated
10/23/2013
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