Provider Demographics
NPI:1740881887
Name:GOODKIND, LILLIAN JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:JEAN
Last Name:GOODKIND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 CHESTNUT ST.
Mailing Address - Street 2:SUITE 2 #1898
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-795-5141
Mailing Address - Fax:
Practice Address - Street 1:2040 LINGLESTOWN RD STE 109
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9568
Practice Address - Country:US
Practice Address - Phone:215-795-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0180621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical