Provider Demographics
NPI:1427716224
Name:GOAD, JAIME ELIZABETH (MED, LPC-A)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:ELIZABETH
Last Name:GOAD
Suffix:
Gender:F
Credentials:MED, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 KELLER PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3755
Mailing Address - Country:US
Mailing Address - Phone:817-431-8900
Mailing Address - Fax:
Practice Address - Street 1:1660 KELLER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3755
Practice Address - Country:US
Practice Address - Phone:817-431-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87365101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional