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General NPI Number Information
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NPI Number | 1154747616
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Entity Type | Individual
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Provider Name | MICHELLE LYNN GODWIN LCSW85811
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Gender | Female
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 5000 WINDPLAY DR STE 2
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9319
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Country | US
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Telephone | 530-903-8548
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2004
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City | DIAMOND SPRINGS
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State | CA
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Zip | 95619-2004
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Country | US
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Telephone | 530-691-2475
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW77868
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW85811
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License Number State | CA
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