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Individual
STEPHANIE GOODRUM
Active
Individual
STEPHANIE GOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC1677
TN
101YP2500X
Professional Counselor
LPC1677
TN
104100000X
Social Worker
LPC 1677
TN
Other
Enumeration date
08/29/2006
Last updated
02/19/2024
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