Healthcare Provider Details

I. General information

NPI: 1912467671
Provider Name (Legal Business Name): LINDSAY GODWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 W MAIN ST
LEHI UT
84043-2050
US

IV. Provider business mailing address

252 W MAIN ST
LEHI UT
84043-2050
US

V. Phone/Fax

Practice location:
  • Phone: 801-980-3676
  • Fax: 801-901-6364
Mailing address:
  • Phone: 801-980-3676
  • Fax: 801-901-6364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number110785
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number13191788-3904
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT110785
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: