Provider Demographics
NPI:1720887094
Name:GOLDTHRIP, WANDA VANESSA GOSS (LPC)
Entity type:Individual
Prefix:MISS
First Name:WANDA
Middle Name:VANESSA GOSS
Last Name:GOLDTHRIP
Suffix:
Gender:
Credentials:LPC
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3716 MAJESTIC DR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7540
Mailing Address - Country:US
Mailing Address - Phone:678-557-0050
Mailing Address - Fax:
Practice Address - Street 1:3716 MAJESTIC DR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7540
Practice Address - Country:US
Practice Address - Phone:678-557-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GALPC009171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional