Provider Demographics
NPI:1396795027
Name:GOULET, CATHY SUE (LPCC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:SUE
Last Name:GOULET
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 GREGORY LN
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-3817
Mailing Address - Country:US
Mailing Address - Phone:859-907-2939
Mailing Address - Fax:859-342-0999
Practice Address - Street 1:495 ERLANGER RD
Practice Address - Street 2:SUITE 204
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1468
Practice Address - Country:US
Practice Address - Phone:859-342-6444
Practice Address - Fax:859-342-0999
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0841101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY184607OtherMEDICARE GROUP NUMBER
KY611371217OtherPRIVATE PRACTICE TAX ID #
KY184607OtherMEDICARE GROUP NUMBER