Provider Demographics
NPI:1285750034
Name:GOODWIN, MARGARET A (PHD, LPCMH, LCPC)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:A
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:PHD, LPCMH, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARBESON
Mailing Address - State:DE
Mailing Address - Zip Code:19951-9484
Mailing Address - Country:US
Mailing Address - Phone:302-562-0025
Mailing Address - Fax:
Practice Address - Street 1:32711 LONG NECK ROAD
Practice Address - Street 2:CEDAR TREE MEDICAL CENTER
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966
Practice Address - Country:US
Practice Address - Phone:302-561-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000877103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEB1-0000877OtherLICENSE IN PSYCHOLOGY
DEPC-0000456OtherLPCMH
MDLC2405OtherLCPC