Individual provider Active NPI

Christy Denny Goodwin, G.S.W.

  • Social Worker
  • Shreveport, LA
National Provider Identifier
1255583621
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
8720 Issued in LA
Practice address
2800 Youree Dr
BLDG 1, Suite 105
Shreveport, LA 71104-3661
Phone
(318) 861-1776
Fax
(318) 868-1788
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8720 LA Primary

Addresses

Primary practice location

2800 Youree Dr
BLDG 1, Suite 105
Shreveport, LA 71104-3661

Mailing address

2800 Youree Dr
BLDG 1, Suite 105
Shreveport, LA 71104-3661
Phone (318) 861-1776

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

LicenseStateTypeSpecialty
8720LAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1255583621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 YOUREE DR",
            "address_2": "BLDG 1, SUITE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043661",
            "telephone_number": "318-861-1776",
            "fax_number": "318-868-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 YOUREE DR",
            "address_2": "BLDG 1, SUITE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043661",
            "telephone_number": "318-861-1776",
            "fax_number": "318-868-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "CHRISTY",
        "middle_name": "DENNY",
        "name_prefix": "Mrs.",
        "credential": "G.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "8720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.