Provider Demographics
NPI:1730451410
Name:GOLDMAN, CINDY SUE (MED, LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:SUE
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6059 MISSION DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-3312
Mailing Address - Country:US
Mailing Address - Phone:248-320-1750
Mailing Address - Fax:
Practice Address - Street 1:26877 NORTHWESTERN HWY
Practice Address - Street 2:SUITE120
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2141
Practice Address - Country:US
Practice Address - Phone:248-320-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008503101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor