Provider Demographics
NPI:1972099174
Name:GOFF, KRISTIANNE LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTIANNE
Middle Name:LOUISE
Last Name:GOFF
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 1:609 S CASCADE AVE APT 528
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3880
Mailing Address - Country:US
Mailing Address - Phone:719-494-9518
Mailing Address - Fax:
Practice Address - Street 1:525 N CASCADE AVE STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3308
Practice Address - Country:US
Practice Address - Phone:720-432-7709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO009927931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical