Provider Demographics
NPI:1245681931
Name:GOODEN, JENNIFER KAY (CADC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:GOODEN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:FLODEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC
Mailing Address - Street 1:4908 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1901
Mailing Address - Country:US
Mailing Address - Phone:515-421-4902
Mailing Address - Fax:515-883-2683
Practice Address - Street 1:4908 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1901
Practice Address - Country:US
Practice Address - Phone:515-421-4902
Practice Address - Fax:515-883-2683
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)