Goudelock, William Michael

Goudelock, William Michael is an sole proprietor health care provider with primary practice located at 1013B West Ave Nw , Lenoir NC 28645-5126. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Goudelock, William Michael can be contacted via phone (828) 572-1636.

Contact Information

Primary practice address
1013B West Ave Nw Lenoir NC 28645-5126
Phone: (828) 572-1636
Fax: (828) 572-1637
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 943 North Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 5495 North Carolina

Profile Details

NPI number 1376605915
LBN Legal business name Goudelock, William Michael
Credentials LPC LCAS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2006
Last updated Oct 22nd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376605915 NPPES
North Carolina MEDICAID 6111785

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