Provider Demographics
NPI:1982848784
Name:GOLDFAIN, CAROL JOLENE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JOLENE
Last Name:GOLDFAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 COUNTY ROAD 13
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-8722
Mailing Address - Country:US
Mailing Address - Phone:970-209-5933
Mailing Address - Fax:
Practice Address - Street 1:211 N IOWA ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2219
Practice Address - Country:US
Practice Address - Phone:970-209-5933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3118101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional