Provider Demographics
NPI:1568807568
Name:MCGOLDRICK, HENRY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:MCGOLDRICK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14522 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3418
Mailing Address - Country:US
Mailing Address - Phone:917-535-5381
Mailing Address - Fax:
Practice Address - Street 1:14522 21ST AVE
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3418
Practice Address - Country:US
Practice Address - Phone:917-535-5381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005379-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health