Provider Demographics
NPI:1437633526
Name:GOETZ, MELANIE (LMFT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:GOETZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2350
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-2350
Mailing Address - Country:US
Mailing Address - Phone:760-271-2507
Mailing Address - Fax:
Practice Address - Street 1:2650 KREMEYER CIR APT 3
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1643
Practice Address - Country:US
Practice Address - Phone:760-453-0373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT128217106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist