Provider Demographics
NPI:1558241489
Name:GOLDMAN, MEGHAN SHARON
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:SHARON
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 NW 3RD ST STE 229
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1757
Mailing Address - Country:US
Mailing Address - Phone:541-447-2631
Mailing Address - Fax:541-508-7517
Practice Address - Street 1:446 NW 3RD ST STE 229
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1757
Practice Address - Country:US
Practice Address - Phone:541-447-2631
Practice Address - Fax:541-508-7517
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health