Provider Demographics
NPI:1881140861
Name:GOODMAN, KAREN M (MED, LPCC,NCC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MED, LPCC,NCC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:10101 LINN STATION RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3848
Mailing Address - Country:US
Mailing Address - Phone:502-589-8600
Mailing Address - Fax:
Practice Address - Street 1:9702 STONESTREET RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-6808
Practice Address - Country:US
Practice Address - Phone:502-589-8920
Practice Address - Fax:502-447-1967
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246049101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty