Provider Demographics
NPI:1306404306
Name:GOLDY, HEATHER KATHLEEN DUNCAN (LICSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:KATHLEEN DUNCAN
Last Name:GOLDY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:KATHLEEN
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:20332 166TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7087
Mailing Address - Country:US
Mailing Address - Phone:425-443-8399
Mailing Address - Fax:
Practice Address - Street 1:2815 EASTLAKE AVE E STE 160
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3194
Practice Address - Country:US
Practice Address - Phone:206-782-0272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605557051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical