Goodman, Penny

Goodman, Penny is an individual health care provider with primary practice located at 10645 N Tatum Blvd Ste 200-370 , Phoenix AZ 85028-3068. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Goodman, Penny can be contacted via phone (480) 810-9020.

Contact Information

Primary practice address
10645 N Tatum Blvd Ste 200-370 Phoenix AZ 85028-3068
Phone: (480) 810-9020
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-2926 Arizona

Profile Details

NPI number 1902866304
LBN Legal business name Goodman, Penny
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Jun 28th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902866304 NPPES
Arizona MEDICAID 736720

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