Individual
MR. TERRY L GOLDADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
316 2ND AVE W, WILLISTON, ND 58801
(701) 774-4600
(701) 774-4620
Mailing address
519 10TH AVE W, WILLISTON, ND 58801
(701) 774-8215
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
840
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26013
BCBS
—
05
—
54516
—
ND
Enumeration date
10/02/2006
Last updated
07/08/2007
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