Individual
ELLEN Y GOODLOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5577 BULLS BAY DR, VIRGINIA BEACH, VA 23462-7189
(757) 581-7957
Mailing address
5577 BULLS BAY DR, VIRGINIA BEACH, VA 23462-7189
(757) 581-7957
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00992252
CO
1041C0700X
Clinical Social Worker
0904014392
VA
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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