Provider Demographics
NPI:1003067430
Name:GOODIN, DONITA K (LPC)
Entity Type:Individual
Prefix:
First Name:DONITA
Middle Name:K
Last Name:GOODIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 E TECUMSEH RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-2752
Mailing Address - Country:US
Mailing Address - Phone:405-464-9536
Mailing Address - Fax:405-321-3448
Practice Address - Street 1:6100 E TECUMSEH RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73026-2752
Practice Address - Country:US
Practice Address - Phone:405-464-9536
Practice Address - Fax:405-321-3448
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health