Provider Demographics
NPI:1033976253
Name:GOODWIN BEHAVIORAL CONSULTANTS, LLC
Entity Type:Organization
Organization Name:GOODWIN BEHAVIORAL CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:517-505-2520
Mailing Address - Street 1:8954 HIDDEN HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:RODNEY
Mailing Address - State:MI
Mailing Address - Zip Code:49342-9529
Mailing Address - Country:US
Mailing Address - Phone:517-505-2520
Mailing Address - Fax:
Practice Address - Street 1:8954 HIDDEN HARBOR DR
Practice Address - Street 2:
Practice Address - City:RODNEY
Practice Address - State:MI
Practice Address - Zip Code:49342-9529
Practice Address - Country:US
Practice Address - Phone:517-505-2520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty