Provider Demographics
NPI:1881727915
Name:GOODWIN, LUCY ANN (ACSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:ANN
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 LEE ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4714
Mailing Address - Country:US
Mailing Address - Phone:828-433-5171
Mailing Address - Fax:
Practice Address - Street 1:145 W PARKER RD
Practice Address - Street 2:STE A
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4628
Practice Address - Country:US
Practice Address - Phone:828-433-5171
Practice Address - Fax:828-433-1127
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0008071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC139FNOtherBLUE CROSS&BLUE SHIELD