Individual
MICHAEL A GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LPC
Contact information
Practice address
203 KENOVA AVE, WAYNE, WV 25570-9795
(304) 272-5136
(304) 272-3807
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 781-5159
(304) 523-8115
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
242
WV
104100000X
Social Worker
CP00452118
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721391
MOUNTAIN STATE BC/BS
WV
Enumeration date
03/29/2006
Last updated
03/14/2016
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