Doctor Name: | MR. BENJAMIN FULMER GOLDRICH |
NPI Number: | 1245611359 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 200 Route 108 Somersworth, NH - 038781119 |
Business Phone Number: | 6039530077 |
Business Fax Number: | |
Mailing Address: | 230 N Craig St, Apartment 408 PITTSBURGH |
State: | PA |
Postal Code: | 152131565 |
Phone Number: | 9148441252 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2015 |
NPI Last Update Date: | 06/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |