Provider Demographics
NPI:1710540984
Name:DANDELION COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:DANDELION COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, LCAS
Authorized Official - Phone:607-759-0146
Mailing Address - Street 1:4909 WATERS EDGE DR STE 100D
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2462
Mailing Address - Country:US
Mailing Address - Phone:984-989-3816
Mailing Address - Fax:984-538-0448
Practice Address - Street 1:4909 WATERS EDGE DR STE 100D
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2462
Practice Address - Country:US
Practice Address - Phone:984-989-3816
Practice Address - Fax:984-538-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health