Provider Demographics
NPI:1497260137
Name:GOODMAN, ABIGAIL ROHAN (LMSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:ROHAN
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:MRS
Other - First Name:ABIGAIL
Other - Middle Name:ROHAN
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5402 ARAPAHO RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-6905
Mailing Address - Country:US
Mailing Address - Phone:972-437-9950
Mailing Address - Fax:
Practice Address - Street 1:16910 DALLAS PKWY STE 116
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1927
Practice Address - Country:US
Practice Address - Phone:972-437-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical