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Individual

ROCHELLE MARIE GOODRICH

Active
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Individual

ROCHELLE MARIE GOODRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
301771
MN
1041C0700X
Clinical Social Worker
Primary
22104
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
666815100
FDLHSD MEDICAIDE
MN
01
NPPOO
FDLHSD MEDICARE
MN
Enumeration date
01/16/2007
Last updated
06/30/2017
About Stedi
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  • EDI platform