Organization
GOOD-ELLIOTT COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP DAVID GOOD-ELLIOTT MSW, LCSW (OWNER)
(574) 535-0880
Entity
Organization
Contact information
Practice address
313 S 3RD ST, GOSHEN, IN 46526-3709
(574) 535-0880
(574) 535-0882
Mailing address
313 S 3RD ST, GOSHEN, IN 46526-3709
(574) 535-0880
(574) 535-0882
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
340004467A
IN
261QM0855X
Adolescent and Children Mental Health Clinic/Center
34004467A
IN
Other
Enumeration date
03/27/2018
Last updated
03/27/2018
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