Provider Demographics
NPI:1639444151
Name:GOAD, LINDA M (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:GOAD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3566 TEAYS VALLEY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9090
Mailing Address - Country:US
Mailing Address - Phone:304-545-0033
Mailing Address - Fax:864-484-8751
Practice Address - Street 1:3566 TEAYS VALLEY RD STE 2
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9090
Practice Address - Country:US
Practice Address - Phone:304-545-0033
Practice Address - Fax:864-484-8751
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2023101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0005355002Medicaid