Provider Demographics
NPI:1053908848
Name:GOOSMANN, KATHLEEN (LPCC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:GOOSMANN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 WOODED VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1052
Mailing Address - Country:US
Mailing Address - Phone:330-410-5812
Mailing Address - Fax:
Practice Address - Street 1:8054 DARROW RD UNIT 6
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2381
Practice Address - Country:US
Practice Address - Phone:474-085-5939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2403976101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional