Provider Demographics
NPI:1528571536
Name:GOODWIN-GOLDEN, JENNIFER (LPC-S)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:GOODWIN-GOLDEN
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HERITAGE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3379
Mailing Address - Country:US
Mailing Address - Phone:729-422-5939
Mailing Address - Fax:
Practice Address - Street 1:1515 HERITAGE DR STE 110
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3379
Practice Address - Country:US
Practice Address - Phone:972-562-9647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70270101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor