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Contact Information

DERESE Z GOODEN, NCC, LCMHC, CCHT
31 S MAIN ST
DAYTON, OH45402-2070
 Phone: 937-860-1038
 Fax: 270-203-0587
 Website:
Indicates primary specialty

NPI Profile & details for DERESE Z GOODEN · (Male)

NPI # 1265957914
Status Active
Credentials NCC, LCMHC, CCHT
Entity Individual
Enumeration date 08/03/2017
Last updated 01/05/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 11725
  • OH License # C.1700611
  • OH Medicaid 0307155
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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