Active NPI
Peter H Goodwin, LMHC
- Mental Health Counselor
- Espanola, NM
National Provider Identifier
1013240308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3132
- Practice address
- 1114 Plaza del Norte
Suite B
Espanola, NM 87532-3216 - Phone
- (505) 753-8933
- Fax
- (505) 753-9811
- NPI assigned
- Sep 17, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 5481 | NM | |
| Mental Health Counselor | 101YM0800X | 3132 | NM | Primary |
Addresses
Primary practice location
1114 Plaza del Norte
Suite B
Espanola, NM 87532-3216
Mailing address
1114 Plaza del Norte
Suite B
Espanola, NM 87532-3216
Phone (505) 753-8933
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5481 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413763200000",
"number": "1013240308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 PLAZA DEL NORTE",
"address_2": "SUITE B",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875323216",
"telephone_number": "505-753-8933",
"fax_number": "505-753-9811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1114 PLAZA DEL NORTE",
"address_2": "SUITE B",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875323216",
"telephone_number": "505-753-8933",
"fax_number": "505-753-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "PETER",
"middle_name": "H",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-17",
"last_updated": "2014-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "5481",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "3132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.