Provider Demographics
NPI:1407397763
Name:DEBORAH GOAD, LMFT
Entity Type:Organization
Organization Name:DEBORAH GOAD, LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOAD
Authorized Official - Suffix:
Authorized Official - Credentials:MRC,MS, LMFT
Authorized Official - Phone:859-806-1955
Mailing Address - Street 1:1029 MONARCH ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1874
Mailing Address - Country:US
Mailing Address - Phone:859-806-1955
Mailing Address - Fax:
Practice Address - Street 1:1029 MONARCH ST
Practice Address - Street 2:SUITE 140
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1874
Practice Address - Country:US
Practice Address - Phone:859-806-1955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY106767106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty