Provider Demographics
NPI:1326583675
Name:GOMANCE, ERIC DANIEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DANIEL
Last Name:GOMANCE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 CENTRAL AVE STE B&C
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-6847
Mailing Address - Country:US
Mailing Address - Phone:501-844-6956
Mailing Address - Fax:501-623-6004
Practice Address - Street 1:1820 CENTRAL AVE STE B&C
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6847
Practice Address - Country:US
Practice Address - Phone:501-623-6000
Practice Address - Fax:601-623-6004
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1907098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional