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Individual

MR. DE'RESE ZYIRE GOODEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NCC, LCMHC, CCHT

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
C.1700611
OH
102L00000X
Psychoanalyst
11725
OH
405300000X
Prevention Professional
Primary
C.1700611
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0307155
OH
Enumeration date
08/03/2017
Last updated
01/05/2025
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