Provider Demographics
NPI:1770817850
Name:GOLDSMITH COUNSELING AND CONSULTING PC
Entity Type:Organization
Organization Name:GOLDSMITH COUNSELING AND CONSULTING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-477-3921
Mailing Address - Street 1:2530 CRAWFORD AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4970
Mailing Address - Country:US
Mailing Address - Phone:847-477-3921
Mailing Address - Fax:847-835-3411
Practice Address - Street 1:2530 CRAWFORD AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4970
Practice Address - Country:US
Practice Address - Phone:847-477-3921
Practice Address - Fax:847-835-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.004968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty