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NPI Code Detail

MEDICARE: MR. VERNER DALMOND GODWIN LPC

MEDICARE:  MR. VERNER DALMOND GODWIN  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6765OK

General Provider Information

NPI Number : 1114939220
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VERNER DALMOND GODWIN LPC
Provider Business Mailing Address
First Line : 204 BURK WAY
Second Line :
City : DEL CITY
State : OK
Zip : 73115-2012
Country : US
Telephone Number : 405-623-1454
Fax Number :
Provider Business Practice Location Address
First Line : 5540 E RENO AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73117-8418
Country : US
Telephone Number : 405-623-1454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 03/26/2019

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