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NPI Code Detail

MEDICARE: KELLY DENISE GODWIN LPC

MEDICARE: KELLY DENISE GODWIN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor89127TX

General Provider Information

NPI Number : 1699628198
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY DENISE GODWIN LPC
Provider Business Mailing Address
First Line : PO BOX 3067
Second Line :
City : CONROE
State : TX
Zip : 77305-3067
Country : US
Telephone Number : 936-521-6100
Fax Number : 936-521-6100
Provider Business Practice Location Address
First Line : 233 SGT ED HOLCOMB BLVD S
Second Line :
City : CONROE
State : TX
Zip : 77304-1990
Country : US
Telephone Number : 936-521-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ KELLY DENISE GODWIN LPC” Practice Location

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