Provider Demographics
NPI:1639210685
Name:GOODMAN, DANIEL C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:C
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:30 HARRIMAN DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2410
Mailing Address - Country:US
Mailing Address - Phone:845-291-2600
Mailing Address - Fax:845-291-2628
Practice Address - Street 1:141 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-6204
Practice Address - Country:US
Practice Address - Phone:845-568-5260
Practice Address - Fax:845-568-5213
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0582671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical