Provider Demographics
NPI:1699147702
Name:GOLDIN, KEITH (LMHC)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:GOLDIN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14550 SW 84TH CT
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1419
Mailing Address - Country:US
Mailing Address - Phone:305-987-2744
Mailing Address - Fax:
Practice Address - Street 1:7800 S RED RD STE 219A
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5523
Practice Address - Country:US
Practice Address - Phone:305-987-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 13426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health