Provider Demographics
NPI:1922485812
Name:GOFFSTEIN, SHELLEY REDMOND (LMHC)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:REDMOND
Last Name:GOFFSTEIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-6006
Mailing Address - Country:US
Mailing Address - Phone:319-930-1264
Mailing Address - Fax:
Practice Address - Street 1:403 N 7TH AVE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-6006
Practice Address - Country:US
Practice Address - Phone:319-338-7518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001468101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health