Provider Demographics
NPI:1851773360
Name:UNION FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:UNION FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-931-8371
Mailing Address - Street 1:1736 DICKERSON BLVD # 142
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2832
Mailing Address - Country:US
Mailing Address - Phone:704-931-8371
Mailing Address - Fax:
Practice Address - Street 1:16147 LANCASTER HWY STE 110
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4196
Practice Address - Country:US
Practice Address - Phone:704-931-8371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-20
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0095461041C0700X, 1041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty