Individual
JAMES PATRICK GOODMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
727 W 2ND ST, BLOOMINGTON, IN 47403-2209
(812) 353-3450
(812) 353-3451
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35002004A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300031245
—
IN
05
—
300044771
—
IN
Enumeration date
08/07/2015
Last updated
02/15/2024
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