Roberta R Goodman, LPAT
Individual provider Active NPI Mental Health Counselor · Tesuque, NM
NPI 1831269448 · NPPES record last updated May 21, 2009
Key facts
- NPI
- 1831269448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 0438 (NM)
- Practice address
- 187 Tesuque Village Rd
Tesuque, NM 87506 - Phone
- (505) 988-3686
- Fax
- (505) 310-1576
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0438 | NM | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0438 | NM | Yes |
Addresses
Primary practice location
187 Tesuque Village Rd
Tesuque, NM 87506
Mailing address
PO Box 1111
Santa Fe, NM 87504-1111
Phone (505) 988-3686
Other providers in Tesuque, NM
- Behavioral Optometry
- Eugene L. Frank MD LLC
- Eugene L Frank
- Richard Dale Juel
- Santa Fe Mountain Center Inc
All providers in Tesuque, NM · Mental Health Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.