Provider Demographics
NPI:1932535572
Name:GOODWIN, LOUISE N (MS, NCC)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:N
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 ROUNDTREE RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3912
Mailing Address - Country:US
Mailing Address - Phone:703-969-4216
Mailing Address - Fax:
Practice Address - Street 1:300 N WASHINGTON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3438
Practice Address - Country:US
Practice Address - Phone:703-888-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-14
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1200037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health