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General NPI Number Information
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NPI Number | 1023244548
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Entity Type | Individual
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Provider Name | CRAIG GOODWIN LPCA
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Gender | Male
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 149 S FRIENDSHIP RD
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City | PADUCAH
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State | KY
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Zip | 42003-5736
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Country | US
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Telephone | 270-551-5245
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Fax | 502-589-8771
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Provider Business Mailing Address
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Address Line | 149 S FRIENDSHIP RD
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City | PADUCAH
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State | KY
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Zip | 42003-5736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 280816
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License Number State | KY
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