Provider Demographics
NPI:1568767127
Name:LYNNE GOLDSMITH
Entity Type:Organization
Organization Name:LYNNE GOLDSMITH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MFT, CPC, NCC, MA
Authorized Official - Phone:775-230-8787
Mailing Address - Street 1:2100 CALIFORNIA ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-7572
Mailing Address - Country:US
Mailing Address - Phone:775-230-8787
Mailing Address - Fax:
Practice Address - Street 1:2100 CALIFORNIA ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-7572
Practice Address - Country:US
Practice Address - Phone:775-230-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCPC0026101YP2500X
NVMFT01121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1386836195Medicaid