Provider Demographics
NPI:1740384221
Name:GOODELL, DANIEL WILLIAM (LCSW)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:GOODELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2211 BLACK HAWK LN
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-9513
Mailing Address - Country:US
Mailing Address - Phone:713-263-4441
Mailing Address - Fax:281-934-2396
Practice Address - Street 1:16300 KATY FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1609
Practice Address - Country:US
Practice Address - Phone:713-263-4441
Practice Address - Fax:281-934-2396
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX518441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical