Provider Demographics
NPI:1447480769
Name:GOSHORN, KERI ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:ANN
Last Name:GOSHORN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:ANN
Other - Last Name:SPEDDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:19 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201
Mailing Address - Country:US
Mailing Address - Phone:717-263-7758
Mailing Address - Fax:717-261-1147
Practice Address - Street 1:19 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-263-7758
Practice Address - Fax:717-261-1147
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
PAPC005249101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional