MALLORY NICOLE GOODWIN LPC
NPI 1013721612
Counselor - Professional in Fort Worth, TX

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since February 04, 2025PECOS Enrolled

3840 HULEN ST, FORT WORTH, TX 76107(817) 335-3022 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mallory Nicole Goodwin Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY NICOLE GOODWIN LPC (NPI 1013721612) is an individual professional provider in Fort Worth, Texas, licensed in Texas (93276) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013721612

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMALLORY NICOLE GOODWINCredential: LPC

Location Address3840 HULEN STFort Worth, TX 76107-7277

Mailing AddressPo Box 2603Fort Worth, TX 76113-2603 · (817) 569-4300

Phone(817) 335-3022

Sole ProprietorNo

Enumeration DateFebruary 4, 2025

Last NPPES UpdateFebruary 23, 2026

NPPES CertifiedFebruary 23, 2026

✔ NPI 1013721612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in TX · 93276

3840 HULEN ST, Fort Worth, TX 76107

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Nicole Goodwin Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.