Crystal R Goforth
Individual provider Active NPI Social Worker · Lexington, KY
NPI 1922436773 · NPPES record last updated Oct 14, 2013
Key facts
- NPI
- 1922436773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 4374 Evangeline LN
Lexington, KY 40509-6901 - Phone
- (859) 684-2220
- NPI assigned
- Oct 14, 2013
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
4374 Evangeline LN
Lexington, KY 40509-6901
Mailing address
4374 Evangeline LN
Lexington, KY 40509-6901
Phone (859) 684-2220
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2013. 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.