Provider Demographics
NPI:1770230161
Name:GOODE, KAREN DONOVAN (LPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DONOVAN
Last Name:GOODE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:DONOVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:107 MIRIAM WAY
Mailing Address - Street 2:
Mailing Address - City:LORETTO
Mailing Address - State:TN
Mailing Address - Zip Code:38469-2027
Mailing Address - Country:US
Mailing Address - Phone:931-244-4850
Mailing Address - Fax:
Practice Address - Street 1:107 MIRIAM WAY
Practice Address - Street 2:
Practice Address - City:LORETTO
Practice Address - State:TN
Practice Address - Zip Code:38469-2027
Practice Address - Country:US
Practice Address - Phone:931-244-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002936101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional