Healthcare Provider Details

I. General information

NPI: 1285750034
Provider Name (Legal Business Name): MARGARET A. GOODWIN PHD, LPCMH, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32711 LONG NECK ROAD CEDAR TREE MEDICAL CENTER
MILLSBORO DE
19966
US

IV. Provider business mailing address

15 DOGWOOD DR
HARBESON DE
19951-9484
US

V. Phone/Fax

Practice location:
  • Phone: 302-561-0290
  • Fax:
Mailing address:
  • Phone: 302-562-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberB1-0000877
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberB1-0000877
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: