Provider Demographics
NPI:1053927566
Name:GOODEN, DENISE PATRICIA (LPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:PATRICIA
Last Name:GOODEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:GOODEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1572 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1753
Mailing Address - Country:US
Mailing Address - Phone:484-719-1905
Mailing Address - Fax:
Practice Address - Street 1:807 W BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5223
Practice Address - Country:US
Practice Address - Phone:610-419-9415
Practice Address - Fax:610-419-9418
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-20
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012667101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional