MS. JESSAMYN K GOODWIN LAC
NPI 1760100069
Counselor - Mental Health in West Fork, AR
Active since August 22, 2022
About Ms. Jessamyn K Goodwin Lac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. JESSAMYN K GOODWIN LAC (NPI 1760100069) is an individual mental health provider in West Fork, Arkansas, licensed in Arkansas (A2010142) and active in the NPI registry since August 2022.
NPPES Registry Identity
NPI1760100069
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. JESSAMYN K GOODWINCredential: LAC
Location Address55 DOGWOOD LNWest Fork, AR 72774-3025
Mailing Address55 Dogwood LnWest Fork, AR 72774-3025 · (479) 263-5662
Phone(479) 263-5662
Sole ProprietorYes
Enumeration DateAugust 22, 2022
NPPES CertifiedAugust 22, 2022
✔ NPI 1760100069 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AR · A2010142
55 DOGWOOD LN, West Fork, AR 72774
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760100069, enumerated as an "individual" on August 22, 2022.
The provider is located at 55 DOGWOOD LN WEST FORK, AR 72774 and the phone number is (479) 263-5662.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
