Provider Demographics
NPI:1275177263
Name:GOODY, CHELSEA CHRISTINE (LCPC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:CHRISTINE
Last Name:GOODY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:C
Other - Last Name:BOPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGPC
Mailing Address - Street 1:350 N GOTWALT ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-5015
Mailing Address - Country:US
Mailing Address - Phone:410-812-6388
Mailing Address - Fax:410-526-9855
Practice Address - Street 1:1122 KENILWORTH DR STE 200
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2139
Practice Address - Country:US
Practice Address - Phone:443-789-7991
Practice Address - Fax:443-921-2919
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-01
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9907101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLGP9907OtherBOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS