Provider Demographics
NPI:1518590637
Name:GOODMAN, ELLIOT RIVER (MSW, LSW)
Entity type:Individual
Prefix:
First Name:ELLIOT
Middle Name:RIVER
Last Name:GOODMAN
Suffix:
Gender:X
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 7TH ST APT 62
Mailing Address - Street 2:
Mailing Address - City:BRADDOCK
Mailing Address - State:PA
Mailing Address - Zip Code:15104-1865
Mailing Address - Country:US
Mailing Address - Phone:412-965-8248
Mailing Address - Fax:
Practice Address - Street 1:1201 S BRADDOCK AVE STE 2
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1275
Practice Address - Country:US
Practice Address - Phone:412-407-7642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker