Provider Demographics
NPI:1871893677
Name:GOODMAN, LOUVIN B (RN CADC III)
Entity type:Individual
Prefix:MRS
First Name:LOUVIN
Middle Name:B
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:RN CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W SEMINARY ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-2358
Mailing Address - Country:US
Mailing Address - Phone:608-647-8821
Mailing Address - Fax:
Practice Address - Street 1:221 W SEMINARY ST
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-2358
Practice Address - Country:US
Practice Address - Phone:608-647-8821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2062-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)