Goodwine, Ida Blan

Goodwine, Ida Blan is an sole proprietor health care provider with primary practice located at 220 Beach 87Th St , Rockaway Beach NY 11693-1604. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Goodwine, Ida Blan can be contacted via phone (718) 318-6536.

Contact Information

Primary practice address
220 Beach 87Th St Rockaway Beach NY 11693-1604
Phone: (718) 318-6536
Fax: (718) 318-6597
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 028031-1 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1629264346
LBN Legal business name Goodwine, Ida Blan
Credentials LMSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2007
Last updated Sep 16th, 2007 - about 17 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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