Provider Demographics
NPI:1528201696
Name:GOODWIN, CRISTIN (MS)
Entity Type:Individual
Prefix:
First Name:CRISTIN
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 WESTFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3878
Mailing Address - Country:US
Mailing Address - Phone:413-592-1980
Mailing Address - Fax:
Practice Address - Street 1:30 DERRYFIELD AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1319
Practice Address - Country:US
Practice Address - Phone:413-531-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor