Individual
MS. SHANNON DANNIELLE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, AAPS
Contact information
Practice address
2627 E CENTRAL AVE, WICHITA, KS 67214-4608
(316) 684-5300
(316) 684-6336
Mailing address
1215 E JUMP ST, WICHITA, KS 67216-1360
(316) 304-3585
(316) 684-6336
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
619
KS
1041C0700X
Clinical Social Worker
Primary
4137
KS
Other
Enumeration date
02/01/2007
Last updated
06/16/2020
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