Michael Goodman, LMFT

Individual provider Active NPI Marriage & Family Therapist · Hurricane, UT

NPI 1558079731 · NPPES record last updated Jun 19, 2024

Key facts

NPI
1558079731
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
13052738-3904 (UT)
Practice address
325 W 600 N
Hurricane, UT 84737-1682
Phone
(855) 587-1416
NPI assigned
Nov 7, 2022
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13052738-3904UTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Liahona Academy for Youth, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 13052738-3904 UT Yes

Addresses

Primary practice location

325 W 600 N
Hurricane, UT 84737-1682

Mailing address

5845 S Sirius Way
St George, UT 84790-1318
Phone (435) 231-4676

Other providers in Hurricane, UT

All providers in Hurricane, UT · Marriage & Family Therapist in Utah

Sources for this page

Verify at the official NPI Registry.