Provider Demographics
NPI:1942609284
Name:GOLDNER, DEANNA (LCSW)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:GOLDNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 BOMAR ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1407
Mailing Address - Country:US
Mailing Address - Phone:908-723-3951
Mailing Address - Fax:
Practice Address - Street 1:4900 TRAVIS ST UNIT 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-2468
Practice Address - Country:US
Practice Address - Phone:908-723-3951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC139341041C0700X
NC0122781041C0700X
TX1074011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical