Provider Demographics
NPI:1093725962
Name:GOODMAN, KAREN W (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:W
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:WOLCHANSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3903 ETON LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-6022
Mailing Address - Country:US
Mailing Address - Phone:512-797-7343
Mailing Address - Fax:512-331-0505
Practice Address - Street 1:12741 RESEARCH BLVD
Practice Address - Street 2:SUITE #300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4388
Practice Address - Country:US
Practice Address - Phone:512-331-6005
Practice Address - Fax:512-331-0505
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS 322011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical