Individual
MISS ANNETTE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
415 E. TRADE STREET, CHARLOTTE, NC 28202
(704) 377-5047
(704) 377-5043
Mailing address
7729 PETREA LN, CHARLOTTE, NC 28227-1061
(704) 491-4011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3206-A
NC
101YM0800X
Mental Health Counselor
3201-A
NC
225C00000X
Rehabilitation Counselor
3206-A
NC
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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