Provider Demographics
NPI:1518471614
Name:GOODE, EVA SOLANGE (LCSW)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:SOLANGE
Last Name:GOODE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4540
Mailing Address - Country:US
Mailing Address - Phone:561-332-1176
Mailing Address - Fax:561-333-3530
Practice Address - Street 1:403 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4540
Practice Address - Country:US
Practice Address - Phone:561-332-1176
Practice Address - Fax:561-333-3530
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW149221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW14922OtherSTATE OF FLORIDA DEPT HEALTH