Active NPI
Jennifer Godwin, BCBA
- Behavior Analyst
- Rock Hill, SC
National Provider Identifier
1700095064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-6-3183
- Practice address
- 2460 India Hook Rd Ste And105
Rock Hill, SC 29732-3530 - Phone
- (803) 366-6250
- Fax
- (803) 905-4431
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-6-3183 | SC | Primary |
Addresses
Primary practice location
2460 India Hook Rd Ste And105
Rock Hill, SC 29732-3530
Mailing address
181 W Professional Park CT Ste 1
Bowling Green, KY 42104-3250
Phone (270) 777-9283
Other practice location 1
2580 Lin Do Ct
Sumter, SC 29150-1832
Phone (803) 905-4427
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EX6562 | Medicaid | SC |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Living in Kentucky, LLC | Behavior Analyst | Past | Accepting new patients |
| Gateway Counseling Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Murray, KY
- NPI 1518281419
Behavior Analyst
-
- Community/Behavioral Health Agency
- Bowling Green, KY
- NPI 1508278458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1700095064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 W PROFESSIONAL PARK CT STE 1",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421043250",
"telephone_number": "270-777-9283",
"fax_number": "270-777-9283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2460 INDIA HOOK RD STE AND105",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297323530",
"telephone_number": "803-366-6250",
"fax_number": "803-905-4431"
}
],
"practiceLocations": [
{
"address_1": "2580 Lin Do Ct",
"address_purpose": "LOCATION",
"city": "Sumter",
"state": "SC",
"postal_code": "291501832",
"country_code": "US",
"telephone_number": "803-905-4427",
"fax_number": "803-905-4431",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GODWIN",
"first_name": "JENNIFER",
"name_prefix": "Miss",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "SC",
"license": "1-6-3183",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EX6562",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.