Provider Demographics
NPI:1295872794
Name:GOODELL, EVELYN ESTHER (LPC)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:ESTHER
Last Name:GOODELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:317 E VAUGHN AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-9301
Mailing Address - Country:US
Mailing Address - Phone:480-813-4833
Mailing Address - Fax:480-813-4833
Practice Address - Street 1:2435 E SOUTHERN AVE
Practice Address - Street 2:#2
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7628
Practice Address - Country:US
Practice Address - Phone:480-209-8118
Practice Address - Fax:480-813-4833
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC1125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional