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Individual

ELAINE R GOODRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
22A OSSIPEE TRAIL WEST, STANDISH, ME 04084
(207) 642-2098
(207) 642-8976
Mailing address
PO BOX 824, STANDISH, ME 04084-0824
(207) 642-2098
(207) 642-8976

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1140
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003850
ANTHEM PIN
ME
01
004846
TRICARE AND HARVARD PILGR
ME
01
1036508
CIGNA PIN
ME
01
149250 (MHS)
VALUE OPTIONS PIN
ME
01
5298100
AETNA BEHAVIORAL HEALTH
ME
Enumeration date
07/13/2006
Last updated
01/13/2010
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