Provider Demographics
NPI:1326265844
Name:GOODIN, JODI LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:LYNN
Last Name:GOODIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:HUGUES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1329 APPLEGATE LN
Mailing Address - Street 2:SOUTHERN INDIANA REHABILITATION HOSPITAL
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129
Mailing Address - Country:US
Mailing Address - Phone:812-283-5992
Mailing Address - Fax:812-283-7069
Practice Address - Street 1:1329 APPLEGATE LN
Practice Address - Street 2:SOUTHERN INDIANA REHABILITATION HOSPTIAL
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129
Practice Address - Country:US
Practice Address - Phone:812-283-5992
Practice Address - Fax:812-283-7069
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005066A1041C0700X, 104100000X
IN20042191A103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker