Provider Demographics
NPI:1063170983
Name:GODDARD, ERIN RAUTH (LCSW)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:RAUTH
Last Name:GODDARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12102 PINEROCK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4210
Mailing Address - Country:US
Mailing Address - Phone:832-754-8227
Mailing Address - Fax:
Practice Address - Street 1:12102 PINEROCK LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4210
Practice Address - Country:US
Practice Address - Phone:832-754-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX599221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical