1043511488 NPI number — GERTRUDE WHITE GOODWIN LPC, ATR

Table of content: GUADALUPE LOZOYA (NPI 1508527136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043511488 NPI number — GERTRUDE WHITE GOODWIN LPC, ATR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOODWIN
Provider First Name:
GERTRUDE
Provider Middle Name:
WHITE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC, ATR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOODWIN
Provider Other First Name:
TRUDI
Provider Other Middle Name:
WHITE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC, ATR
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1043511488
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1215 N AUGUSTA ST
Provider Second Line Business Mailing Address:
PEOPLE PLACES, INC. STAUNTON
Provider Business Mailing Address City Name:
STAUNTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24401-3203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-885-8841
Provider Business Mailing Address Fax Number:
540-886-6379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1002 E JEFFERSON ST
Provider Second Line Business Practice Location Address:
PEOPLE PLACES, INC. CHARLOTTESVILLE
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22902-5328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-979-0335
Provider Business Practice Location Address Fax Number:
434-979-0202
Provider Enumeration Date:
11/16/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  0701004752 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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