Provider Demographics
NPI:1023159738
Name:GOODMAN, ELIZABETH HADDEN (LMFT LPCC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:HADDEN
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:LMFT LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 THIRD STREET, SUITE 39
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501
Mailing Address - Country:US
Mailing Address - Phone:707-499-4111
Mailing Address - Fax:707-444-8882
Practice Address - Street 1:517 THIRD STREET SUITE 39
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501
Practice Address - Country:US
Practice Address - Phone:707-499-4111
Practice Address - Fax:707-444-8882
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist