Provider Demographics
NPI:1124265392
Name:OVERBERG GOODRICK, MONICA J (LMHC, LCPC)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:J
Last Name:OVERBERG GOODRICK
Suffix:
Gender:F
Credentials:LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 E KIMBERLY RD STE 265N
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-7224
Mailing Address - Country:US
Mailing Address - Phone:563-526-3481
Mailing Address - Fax:563-526-7631
Practice Address - Street 1:2322 E KIMBERLY RD STE 265N
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-7224
Practice Address - Country:US
Practice Address - Phone:563-526-3481
Practice Address - Fax:563-526-7631
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007087101Y00000X
IA001392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor