Individual
MRS. SUSAN JARRETT GOODENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2808 FOX CHASE LN, MIDLOTHIAN, VA 23112-4008
(804) 977-0656
Mailing address
2808 FOX CHASE LN, MIDLOTHIAN, VA 23112-4008
(804) 977-0656
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717002031
VA
106H00000X
Marriage & Family Therapist
51113
CA
106H00000X
Marriage & Family Therapist
MFT.0001044
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026490
KAISER COMMERCIAL NUMBER
CO
05
—
56123353
—
CO
Enumeration date
01/11/2008
Last updated
11/14/2023
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