Individual
ANNALAURA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9250 COLUMBIA AVE STE 2E, MUNSTER, IN 46321-3530
(219) 595-0043
(219) 237-2894
Mailing address
9250 COLUMBIA AVE STE 2E, MUNSTER, IN 46321-3530
(219) 595-0043
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007725A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MEDICARE
945770015
IN
Enumeration date
02/16/2012
Last updated
06/23/2020
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