Provider Demographics
NPI:1033808183
Name:GOODINE COUNSELING LTD
Entity Type:Organization
Organization Name:GOODINE COUNSELING LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOODINE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:920-660-9797
Mailing Address - Street 1:2123 NELLIE LN
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6068
Mailing Address - Country:US
Mailing Address - Phone:920-660-9797
Mailing Address - Fax:
Practice Address - Street 1:2300 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-1900
Practice Address - Country:US
Practice Address - Phone:920-362-0447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health