STEPHANIE GOODRUM LPC NPI 1972611788

NPI Information

NPI: 1972611788
Provider Name: STEPHANIE GOODRUM, LPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
641 E POPLAR AVE
SELMER, TN
ZIP 38375
Phone: (731) 645-5753
Get Directions

Stephanie Goodrum, LPC is a mental health counselor in Selmer, TN with 28 years of experience. Stephanie Goodrum, LPC NPI is 1972611788. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

641 E POPLAR AVE
SELMER, TN
ZIP 38375-828
Phone: (731) 645-5753
Fax: (731) 645-9885

The NPI 1972611788 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 2/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	101YP2500X	Counselor	Professional	LPC1677	TENNESSEE	No
2	104100000X	Social Worker		LPC 1677	TENNESSEE	No
3	101YM0800X	Counselor	Mental Health	LPC1677	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4099873	OTHER	TENNESSEE	BCBS PROVIDER NUMBER
2	572994000	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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