Individual
JENNIFER W. GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
55 BELL ST, PORTLAND, ME 04103-3418
(207) 205-5741
(207) 514-8333
Mailing address
75 GRANITE ST, PORTLAND, ME 04102-2844
(207) 205-5741
(207) 514-8333
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1825
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309510099
—
ME
Enumeration date
08/12/2006
Last updated
12/06/2021
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