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:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245621507 | NPPES |
| Other | 11861990 | CAQH |
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