Yanku, Lisa Goodman
Yanku, Lisa Goodman is an individual health care provider with primary practice located at 1337 E Garrison Blvd , Gastonia NC 28054-5127. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Yanku, Lisa Goodman can be contacted via phone (704) 834-2000.Contact Information
Primary practice address
1337 E Garrison Blvd
Gastonia NC 28054-5127
Phone: (704) 834-2000
Fax: (704) 854-3086
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ISW00498 | Rhode Island |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C009243 | North Carolina |
Profile Details
| NPI number | 1568470367 |
|---|---|
| LBN Legal business name | Yanku, Lisa Goodman |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 4th, 2006 |
| Last updated | Apr 30th, 2024 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568470367 | NPPES |
| Rhode Island | Other | 62-67493 | UBH |
| Rhode Island | Other | 408503 | UBH |
| Rhode Island | Other | 30118-1 | UBH |
| Rhode Island | MEDICAID | LY10977 | UBH |
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