Provider Demographics
NPI:1962053827
Name:GOINS, FAITH (SWT)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:GOINS
Suffix:
Gender:F
Credentials:SWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W LAKESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1044
Mailing Address - Country:US
Mailing Address - Phone:216-443-8250
Mailing Address - Fax:
Practice Address - Street 1:310 W LAKESIDE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1044
Practice Address - Country:US
Practice Address - Phone:216-443-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1901010-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker