Jennifer L Goodwin, MA, LMHC, CDP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00003715 Issued in WA

Practice address

1408 State Ave NE
Olympia, WA 98506-4481

Phone

(360) 357-5003

Fax

(360) 357-5203

NPI assigned

May 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 6, 2025 through Feb 6, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Olympia Psychotherapy Inc

  • Community/Behavioral Health Agency
  • Olympia, WA
  • NPI 1104267558
  NPD (past) Authorized official

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1396793725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 STATE AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985064481",
            "telephone_number": "360-357-5003",
            "fax_number": "360-357-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 STATE AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985064481",
            "telephone_number": "360-357-5003",
            "fax_number": "360-357-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MA, LMHC, CDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00003715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jennifergoodwinsimplepractice.com",
            "affiliation": "N",
            "endpointDescription": "Hipaa  compliant messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Messaging and documents",
            "address_1": "1408 State Ave NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985064481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Moshe Goodblatt, M.D.
• Penelope Anne Goode, M.D.
• Linda Kay Gooding, RD
• Tracy Goodnight, CCC-SLP
• Janine Goodwin, CMA
• Ben Goold, MD
• Alicia A Gooley
• Gordon Yamaguchi DDS PS
• Alisha Nicole Gordon
• Erik Keith Gordon

• Mental Health Counselor in Olympia, WA
• Providers in Olympia, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.