Provider Demographics
NPI:1497192025
Name:GOODSON, ERIN RACHESKY (LMHC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:RACHESKY
Last Name:GOODSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:RACHESKY
Other - Last Name:STIRN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:259 E OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-3547
Mailing Address - Country:US
Mailing Address - Phone:850-682-1234
Mailing Address - Fax:
Practice Address - Street 1:259 E OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-3547
Practice Address - Country:US
Practice Address - Phone:850-682-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH10787101YM0800X
FLMH18107101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health