Provider Demographics
NPI:1922414739
Name:GOODACRE, TAMARA (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:GOODACRE
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 1:4868 POST POINTE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3516
Mailing Address - Country:US
Mailing Address - Phone:941-706-1524
Mailing Address - Fax:
Practice Address - Street 1:4868 POST POINTE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3516
Practice Address - Country:US
Practice Address - Phone:941-706-1524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW119701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical