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Individual
MS. MYRA GOELLER
Active
Individual
MS. MYRA GOELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6674
NY
101YM0800X
Mental Health Counselor
R049409-2
NY
1041C0700X
Clinical Social Worker
Primary
R049409
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02455392
—
NY
01
—
049409-B37
HEALTHFIRST
NY
01
—
100674P
HIP
NY
01
—
156994
VALUE OPTIONS
NY
01
—
2108404
CIGNA BEHAVIORAL HEALTH
NY
01
—
7482515
GHI-BMP CITY OF NY
NY
Enumeration date
12/20/2006
Last updated
07/08/2014
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