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:
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Health care specialties

SpecialtyCodeLicense #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 8 months 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 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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