Provider Demographics
NPI:1801544192
Name:GOYKHMAN, NATHALIE ISABELLE (LPC)
Entity type:Individual
Prefix:
First Name:NATHALIE
Middle Name:ISABELLE
Last Name:GOYKHMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COTTON ST APT 238
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1555
Mailing Address - Country:US
Mailing Address - Phone:267-266-0828
Mailing Address - Fax:
Practice Address - Street 1:1811 BETHLEHEM PIKE STE 234
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1111
Practice Address - Country:US
Practice Address - Phone:215-948-3546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAR-DMT-2445225600000X
PAPC013926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist