Provider Demographics
NPI:1033207709
Name:GOYETTE, NICOLE DAUNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:DAUNE
Last Name:GOYETTE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4013
Mailing Address - Country:US
Mailing Address - Phone:603-224-7479
Mailing Address - Fax:603-224-7445
Practice Address - Street 1:13 GREEN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4013
Practice Address - Country:US
Practice Address - Phone:603-224-7479
Practice Address - Fax:603-224-7445
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical