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General NPI Number Information
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NPI Number | 1497388409
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Entity Type | Individual
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Provider Name | ARRIE MATTHEW GODWIN LPC
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Gender | Male
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 2003 MEDICAL PKWY STE C
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City | SAN MARCOS
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State | TX
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Zip | 78666-7554
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Country | US
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Telephone | 512-643-5440
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Fax |
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Provider Business Mailing Address
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Address Line | 255 MICHAELIS UNIT B
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City | KYLE
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State | TX
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Zip | 78640-4394
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Country | US
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Telephone | 512-757-2037
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 71203
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License Number State | TX
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