Active NPI
Gary D. Goodwin, LCSW
- Clinical Social Worker
- Snowflake, AZ
National Provider Identifier
1760873004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW 15444
- Practice address
- 440 S 2ND St W
Snowflake, AZ 85937-5218 - Phone
- (928) 243-8172
- NPI assigned
- Feb 9, 2015
- Last updated
- Feb 9, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW 15444 | AZ | Primary |
Addresses
Primary practice location
440 S 2ND St W
Snowflake, AZ 85937-5218
Mailing address
440 S 2ND St W
Snowflake, AZ 85937-5218
Phone (928) 243-8172
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW 15444 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1760873004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 S 2ND ST W",
"city": "SNOWFLAKE",
"state": "AZ",
"postal_code": "859375218",
"telephone_number": "928-243-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 S 2ND ST W",
"city": "SNOWFLAKE",
"state": "AZ",
"postal_code": "859375218",
"telephone_number": "928-243-8172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "GARY",
"middle_name": "D.",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-09",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW 15444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snowflake, AZ
- Eagledancer Youth and Family Services, Inc.
- Lorraine Ferrante, IBCLC, BSW, LPN, DEM
- James Scott Flake, SCHOOL PSYCHOLOGIST
- Connie Kaye Gardner, M.S.
- Jacquelyn Leah Garrett Allen, P.T.
- Gwendolyn Lee Hall CNM Inc (Snowflake Heber Women's Clinic)
- Gwendolyn Lee Hall, CNM (Snowflake/Heber Women's Clinic)
- Wendy Lee Hall, CNM
- Michelle Hardesty, FAMILY NURSE PRACTIT
- Hatch Haven, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.