Provider Demographics
NPI:1659653517
Name:GOODMAN, ALAINA KAY (MA, LMHC)
Entity type:Individual
Prefix:
First Name:ALAINA
Middle Name:KAY
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:KAY
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:19022 114TH CT SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-7172
Mailing Address - Country:US
Mailing Address - Phone:425-306-6014
Mailing Address - Fax:425-272-4365
Practice Address - Street 1:119 PELLY AVE N
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5714
Practice Address - Country:US
Practice Address - Phone:425-306-6014
Practice Address - Fax:425-272-4365
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60217484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health