MRS. MARY GOODNER, LCSW - NPI NUMBER 1598920803

Summary

Provider Name: MRS. MARY GOODNER, LCSW

NPI Number: 1598920803

Clasification: Counselor (101YM0800X)

Specialization: Mental Health

Address:
500 PARK AVE
LEBANON, TN
ZIP 37087

Phone Number: (615) 449-0500



Detailed Information

MRS. Mary Goodner, LCSW is a mental health counselor in Lebanon, TN. The assigned NPI number for this provider is 1598920803 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

500 PARK AVE
LEBANON, TN
ZIP 37087-721
Phone: (615) 449-0500

The enumeration date for this NPI number is 7/25/2008 and was last updated on 7/25/2008.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 101YM0800X Counselor Mental Health 4981 TN Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 4981 OTHER TN LICENSED CLINICAL SOCIAL WORKER LICENSE NUMBER

NPI Record

No. Field Name Field Value
1 NPI 1598920803
2 Entity Type Code 1
3 Provider Last Name Legal Name GOODNER
4 Provider First Name MARY
5 Provider Name Prefix Text MRS.
6 Provider Credential Text LCSW
7 Provider Other Last Name GOODNER
8 Provider Other First Name BETH
9 Provider Other Last Name Type Code 2
10 Provider First Line Business Practice Location Address 500 PARK AVE
11 Provider Business Practice Location Address City Name LEBANON
12 Provider Business Practice Location Address State Name TN
13 Provider Business Practice Location Address Postal Code 370873721
14 Provider Business Practice Location Address Country Code If outside U S US
15 Provider Business Practice Location Address Telephone Number 6154490500
16 Provider Enumeration Date 7/25/2008
17 Last Update Date 7/25/2008
18 Provider Gender Code F
19 Healthcare Provider Taxonomy Code 1 101YM0800X
20 Provider License Number 1 4981
21 Provider License Number State Code 1 TN
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 4981
24 Other Provider Identifier Type Code 1 01
25 Other Provider Identifier State 1 TN
26 Other Provider Identifier Issuer 1 LICENSED CLINICAL SOCIAL WORKER LICENSE NUMBER
27 Is Sole Proprietor Y

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This page was last updated on: 4/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.