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General NPI Number Information
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NPI Number | 1235345794
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Entity Type | Individual
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Provider Name | CYNTHIA GOODWIN WOMACK DHS, MN.LMFT,CNS/PMH
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 1024 FOUNDERS ROW
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City | GREENSBORO
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State | GA
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Zip | 30642-5260
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Country | US
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Telephone | 404-261-7902
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Fax | 404-841-9296
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Provider Business Mailing Address
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Address Line | 126 LULLWATER LN
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City | EATONTON
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State | GA
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Zip | 31024-5639
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Country | US
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Telephone | 404-261-7902
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Fax | 706-485-5905
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 626
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | R027373
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License Number State | GA
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