Provider Demographics
NPI:1043511488
Name:GOODWIN, GERTRUDE WHITE (LPC, ATR)
Entity Type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:WHITE
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:TRUDI
Other - Middle Name:WHITE
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, ATR
Mailing Address - Street 1:1215 N AUGUSTA ST
Mailing Address - Street 2:PEOPLE PLACES, INC. STAUNTON
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-3203
Mailing Address - Country:US
Mailing Address - Phone:540-885-8841
Mailing Address - Fax:540-886-6379
Practice Address - Street 1:1002 E JEFFERSON ST
Practice Address - Street 2:PEOPLE PLACES, INC. CHARLOTTESVILLE
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5328
Practice Address - Country:US
Practice Address - Phone:434-979-0335
Practice Address - Fax:434-979-0202
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004752101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional