1205903291 NPI number — MS. JOANNE D GOER LPC LCADC CMS

Table of content: MS. JOANNE D GOER LPC LCADC CMS (NPI 1205903291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205903291 NPI number — MS. JOANNE D GOER LPC LCADC CMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOER
Provider First Name:
JOANNE
Provider Middle Name:
D
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC LCADC CMS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205903291
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 EVANS PLACE
Provider Second Line Business Mailing Address:
NEW BRIDGE SERVICES INC
Provider Business Mailing Address City Name:
POMPTON PLAINS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-907-2700
Provider Business Mailing Address Fax Number:
973-839-4770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
390 MAIN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-316-9333
Provider Business Practice Location Address Fax Number:
973-316-5790
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  37LC00032600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YP2500X , with the licence number: 37PC00082000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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