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Individual

SUSAN S GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
918 ORMSBY LN, LOUISVILLE, KY 40242-4536
(502) 327-4622
(502) 327-4675
Mailing address
PO BOX 6728, LOUISVILLE, KY 40206-0728
(502) 327-4622
(502) 327-4675

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0626
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8200102500
KY
Enumeration date
06/27/2005
Last updated
05/21/2019
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