Provider Demographics
NPI:1316032725
Name:GODWIN, MIRIAM CLAIRE (MS, LMFT)
Entity type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:CLAIRE
Last Name:GODWIN
Suffix:
Gender:
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 BEAVER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2019
Mailing Address - Country:US
Mailing Address - Phone:252-916-9835
Mailing Address - Fax:
Practice Address - Street 1:2534 BEAVER CREEK RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2019
Practice Address - Country:US
Practice Address - Phone:252-916-9835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105116Medicaid