Provider Demographics
NPI:1093958662
Name:GOCH, DONNA L (LPC, CAADC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:L
Last Name:GOCH
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2329
Mailing Address - Country:US
Mailing Address - Phone:517-548-0081
Mailing Address - Fax:517-548-0498
Practice Address - Street 1:622 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2329
Practice Address - Country:US
Practice Address - Phone:517-548-0081
Practice Address - Fax:517-548-0498
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-00067101YA0400X
MI6401010491101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)