Provider Demographics
NPI:1780334078
Name:GOOEN, LEAH (LCSW)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:GOOEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16-41 PARMELEE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1937
Mailing Address - Country:US
Mailing Address - Phone:973-862-0348
Mailing Address - Fax:
Practice Address - Street 1:16-41 PARMELEE AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1937
Practice Address - Country:US
Practice Address - Phone:516-441-7944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4SC061928001041C0700X
NY0899221041C0700X
CT0152121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical