Provider Demographics
NPI:1437758109
Name:GOODMAN, KRISTIN COLLEEN (LCMHC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:COLLEEN
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BROADVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1004
Mailing Address - Country:US
Mailing Address - Phone:828-929-0871
Mailing Address - Fax:
Practice Address - Street 1:29 N MARKET ST STE 300
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2924
Practice Address - Country:US
Practice Address - Phone:828-929-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016603101YM0800X
NC17598101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional