Provider Demographics
NPI:1013703818
Name:GOODMAN, HEATHER R (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:R
Last Name:GOODMAN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2273 SHAKERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-8529
Mailing Address - Country:US
Mailing Address - Phone:606-226-0805
Mailing Address - Fax:
Practice Address - Street 1:2273 SHAKERTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-8529
Practice Address - Country:US
Practice Address - Phone:606-226-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2577331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical