Provider Demographics
NPI:1912770371
Name:GOODCOFF, LEAH (LMHC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:GOODCOFF
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KINGS CT APT 5
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1751
Mailing Address - Country:US
Mailing Address - Phone:518-727-2441
Mailing Address - Fax:
Practice Address - Street 1:135 OLD COVE RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-3767
Practice Address - Country:US
Practice Address - Phone:315-217-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health