Provider Demographics
NPI:1750850038
Name:GOODWIN, CHERYL Y
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:Y
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-0388
Mailing Address - Country:US
Mailing Address - Phone:803-635-2335
Mailing Address - Fax:803-635-9695
Practice Address - Street 1:178 US HIGHWAY 321 N
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-0388
Practice Address - Country:US
Practice Address - Phone:803-635-2335
Practice Address - Fax:803-635-9695
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)