Individual
SUE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
667 MARLBERRY PL, HENDERSON, NV 89015-7475
(313) 732-7332
(702) 388-4358
Mailing address
667 MARLBERRY PL, HENDERSON, NV 89015-7475
(313) 732-7332
(702) 388-4358
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NV
101YM0800X
Mental Health Counselor
—
NV
103K00000X
Behavior Analyst
Primary
—
NV
104100000X
Social Worker
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101066
—
AZ
05
—
101066
—
CA
05
—
101066
—
FL
05
—
101066
—
GA
05
—
101066
—
IL
05
—
101066
—
LA
05
—
101066
—
MI
05
—
101066
—
NV
05
—
101066
—
OH
05
—
101066
—
TN
05
—
101066
—
TX
Enumeration date
02/15/2013
Last updated
02/15/2013
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