Provider Demographics
NPI:1730946815
Name:GOODSON COUNSELING PRACTICE
Entity type:Organization
Organization Name:GOODSON COUNSELING PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:334-790-8362
Mailing Address - Street 1:105 PRESTWICK DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1213
Mailing Address - Country:US
Mailing Address - Phone:334-790-8362
Mailing Address - Fax:
Practice Address - Street 1:105 PRESTWICK DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1213
Practice Address - Country:US
Practice Address - Phone:334-790-8362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty