Provider Demographics
NPI:1447311808
Name:GOFF, BEVERLEY (LCSW)
Entity type:Individual
Prefix:MS
First Name:BEVERLEY
Middle Name:
Last Name:GOFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BADGER ST
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-7231
Mailing Address - Country:US
Mailing Address - Phone:845-735-7349
Mailing Address - Fax:
Practice Address - Street 1:8 BADGER ST
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-7231
Practice Address - Country:US
Practice Address - Phone:845-735-7349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR193021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical