Provider Demographics
NPI:1174831853
Name:MEYER-GOODWIN, STEFANIE DORA (LMHC LMFT)
Entity Type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:DORA
Last Name:MEYER-GOODWIN
Suffix:
Gender:F
Credentials:LMHC LMFT
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:DORA
Other - Last Name:LINDLAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC LMFT
Mailing Address - Street 1:11315 CORPORATE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-8340
Mailing Address - Country:US
Mailing Address - Phone:407-534-0186
Mailing Address - Fax:321-972-3982
Practice Address - Street 1:11315 CORPORATE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-8340
Practice Address - Country:US
Practice Address - Phone:407-534-0186
Practice Address - Fax:321-972-3982
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2812106H00000X
FLMH11960101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1164581633OtherSBH AGENCY NPI