Individual
MR. ANDREW L GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
211 W 56TH ST, 31 G, NEW YORK, NY 10019-4312
(212) 974-0104
Mailing address
211 W 56TH ST, 31G, NEW YORK, NY 10019-4312
(212) 974-0104
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PR022690-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004598
GHI PROVIDER NUMBER
NY
01
—
P403128
OXFORD PROVIDER NUMBER
NY
Enumeration date
03/11/2007
Last updated
07/08/2007
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