Provider Demographics
NPI:1437347572
Name:GODWIN, ELIZABETH L (MFT ASSOCIATE)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:L
Last Name:GODWIN
Suffix:
Gender:F
Credentials:MFT ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 APPLETON RD
Mailing Address - Street 2:
Mailing Address - City:CASTLEBERRY
Mailing Address - State:AL
Mailing Address - Zip Code:36432-5542
Mailing Address - Country:US
Mailing Address - Phone:251-578-0017
Mailing Address - Fax:251-578-2405
Practice Address - Street 1:101 PERRYMAN STREET HWY 31
Practice Address - Street 2:COMPASS ACADEMY
Practice Address - City:EVERGREEN
Practice Address - State:AL
Practice Address - Zip Code:36401
Practice Address - Country:US
Practice Address - Phone:251-578-0017
Practice Address - Fax:251-578-2405
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALASSOCIATE # 58101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health