Organization
REGINA GOODMAN, L.C.S.W., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA GOODMAN LCSW (SOLE MEMBER)
(414) 828-3634
Entity
Organization
Contact information
Practice address
777 N JEFFERSON ST STE 402, MILWAUKEE, WI 53202-3713
(414) 502-9245
Mailing address
777 N JEFFERSON ST STE 402, MILWAUKEE, WI 53202-3713
(414) 502-9245
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42184700
—
WI
Enumeration date
06/08/2020
Last updated
07/15/2022
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