Provider Demographics
NPI:1134457385
Name:GOODMAN, JOAN BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:BETH
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11300 ROCKVILLE PIKE
Mailing Address - Street 2:#914
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3003
Mailing Address - Country:US
Mailing Address - Phone:301-881-0433
Mailing Address - Fax:
Practice Address - Street 1:11300 ROCKVILLE PIKE
Practice Address - Street 2:#914
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3003
Practice Address - Country:US
Practice Address - Phone:301-881-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical