Individual provider · NPI-1
Annette Goodman, LCAS-A
Counselor, Addiction (Substance Use Disorder) · Charlotte, NC
NPI number1801236484
StatusActive
Last updated in NPPESJun 27, 2013
Details
- NPI
- 1801236484
- Entity type
- Individual (NPI-1)
- Name
- Miss Annette Goodman
- Credential
- LCAS-A
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 27, 2013
- Last updated
- Jun 27, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 3206-A | NC | Yes |
| 101YM0800X | Counselor, Mental Health | 3201-A | NC | |
| 225C00000X | Rehabilitation Counselor | 3206-A | NC |
Practice location
415 E. Trade StreetCharlotte, NC 28202
Phone 704-377-5047 · Fax 704-377-5043
Mailing address
7729 Petrea LnCharlotte, NC 28227-1061
Phone 704-491-4011
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