Provider Demographics
NPI:1790160950
Name:GOODNATURE, ELLEN SUE (LCPC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:SUE
Last Name:GOODNATURE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-5000
Mailing Address - Country:US
Mailing Address - Phone:405-234-0234
Mailing Address - Fax:406-234-0235
Practice Address - Street 1:1201 W HOLLY ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-3596
Practice Address - Country:US
Practice Address - Phone:406-433-4635
Practice Address - Fax:406-433-8201
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health