Provider Demographics
NPI:1013992064
Name:GOODKIND, PATRICE E (MSW, LISW)
Entity Type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:E
Last Name:GOODKIND
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 CARRIAGE HOUSE
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-3769
Mailing Address - Country:US
Mailing Address - Phone:505-662-4637
Mailing Address - Fax:505-662-4637
Practice Address - Street 1:555 OPPENHEIMER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2384
Practice Address - Country:US
Practice Address - Phone:505-662-4663
Practice Address - Fax:505-662-4637
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-42971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical