Individual
AMY E GOODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 MALLETT DR, TOPSHAM, ME 04086-1313
(207) 272-0744
Mailing address
1 MALLETT DR, TOPSHAM, ME 04086-1313
(207) 272-0744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC14655
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518331032
—
ME
Enumeration date
02/02/2021
Last updated
02/02/2021
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