Provider Demographics
NPI:1902640402
Name:GOEBELBECKER, LISABETH R (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:LISABETH
Middle Name:R
Last Name:GOEBELBECKER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 14TH AVENUE DR NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2203
Mailing Address - Country:US
Mailing Address - Phone:828-234-0712
Mailing Address - Fax:
Practice Address - Street 1:4730 PARK RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-4205
Practice Address - Country:US
Practice Address - Phone:704-800-4436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health