Provider Demographics
NPI:1518776541
Name:GOODLING, SHELLY (LGPC)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:
Last Name:GOODLING
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W MARKET ST STE 406
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1252
Mailing Address - Country:US
Mailing Address - Phone:717-659-3730
Mailing Address - Fax:
Practice Address - Street 1:9419 COMMON BROOK RD STE 208
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7570
Practice Address - Country:US
Practice Address - Phone:410-864-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15609101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor