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Individual

WENDY GOODMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC, LADAC, LPCC

Contact information

Practice address
2859 PLAZA ROJO, SANTA FE, NM 87507-6521
(505) 474-6825
(505) 474-6825
Mailing address
2859 PLAZA ROJO, SANTA FE, NM 87507-6521
(505) 474-6825
(505) 474-6825

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0122491
NM
101YM0800X
Mental Health Counselor
0111261
NM
101YM0800X
Mental Health Counselor
Primary
0127551
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1558539619
NM
Enumeration date
02/12/2008
Last updated
03/27/2011
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