Provider Demographics
NPI:1558686873
Name:GOOD, SARAH (LLPC, LLMFT, NCC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GOOD
Suffix:
Gender:F
Credentials:LLPC, LLMFT, NCC
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 19696
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49019-0696
Mailing Address - Country:US
Mailing Address - Phone:269-353-7607
Mailing Address - Fax:
Practice Address - Street 1:426 SOLON ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4289
Practice Address - Country:US
Practice Address - Phone:269-353-7607
Practice Address - Fax:269-344-0453
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011354101YP2500X
MI4101006422106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist