Goodwin, Kimberly Lynn

Goodwin, Kimberly Lynn is an sole proprietor health care provider with primary practice located at 25490 Little Mack Ave , Saint Clair Shores MI 48081-2157. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Nursing Service Providers / Rehabilitation. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Goodwin, Kimberly Lynn can be contacted via phone (586) 246-7837.

Contact Information

Primary practice address
25490 Little Mack Ave Saint Clair Shores MI 48081-2157
Phone: (586) 246-7837
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 6401010236 Michigan
Nursing Service Providers / Rehabilitation 163WR0400X 4704247001 Michigan

Profile Details

NPI number 1245621507
LBN Legal business name Goodwin, Kimberly Lynn
Credentials BSN, MRC, CRC, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2015
Last updated Oct 21st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245621507 NPPES
Other 11861990 CAQH

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